Director of Emergency Ultrasound NYU Langone Long Island Floral Park, New York
Disclosure(s): No financial relationships to disclose
Disclosure(s):
Yash Chavda, DO, MBA, FAAEM: No financial relationships to disclose
Rhabdomyolysis is a frequently encountered yet inconsistently managed condition in emergency departments. Traditional teaching emphasizes CK thresholds, aggressive IV fluid resuscitation, and universal admission. However, emerging evidence challenges these norms and calls for a more nuanced approach to diagnosis and management.
This Breve Dulce session will deliver a concise, evidence-based update on rhabdo in the ED. We will clarify when creatine kinase (CK) levels truly correlate with renal injury, when and how to initiate fluid resuscitation, and, most importantly, who actually requires hospital admission. Learners will be introduced to practical risk stratification tools like the McMahon Score to assess renal failure risk, and we’ll examine why CK alone is not sufficient for clinical decision-making.
We will also review the growing role of balanced crystalloids like lactated Ringer’s over normal saline, and discuss why sodium bicarbonate and mannitol are falling out of favor in ED management. The talk will conclude with a simplified, pragmatic disposition framework for determining which rhabdo patients can be safely discharged with follow-up.
Attendees will leave with an actionable mental model: “CK is the headline — kidneys and potassium are the story.”
Learning Objectives:
Identify which laboratory findings, beyond CK, influence the risk of complications in rhabdomyolysis.
Apply current evidence to guide fluid selection and avoid unnecessary bicarbonate use.
Utilize clinical criteria and risk tools to determine safe ED discharge vs admission
