I do not watch House but the scenario you describe suggests that the concern was hyperkalemia (high potassium). See my post above for how this might happen. Potassium is contained inside the cells, so damaging the cells releases potassium. High potassium in the blood stream (instead of inside the cells) can cause cardiac arrest. Acute hyperkalemia creates some fairly pathognomonic EKG changes so EKG monitoring can suggest hyperkalemia faster than waiting for a blood test to be returned. When we see those changes and suspect hyperkalemia we administer calcium intravenously immediately as it helps counteract the effect until we can do other things to actually lower the potassium level.
From your description, the House timing was a little different; perhaps they proposed a scenario where acute renal failure precipitated by rhadomyolysis caused an inability to clear potassium (excess potassium is normally peed out if you have normal kidneys) and only then did the excess potassium load from the crushed cells become clinically significant. Without having seen the show I can’t comment. A very high immediate intravenous load of potassium will kill you even with normal kidneys because they don’t have time to clear it.
MAST trousers, as referenced, have largely fallen out of favor for most traumatic emergencies.
You’re correct, I was just comparing their effect with that of a lower body crush injury. I didn’t mean to confuse.
Remember, I’m an old bat. I was involved with the removal of said pants a few times, most often, incorrectly, by impatient surgeons. Of course that was 20, wait no, more like 30 years ago. (damn, how diid I get this old?!?)
They just had a death where a man was bisected by a semi, and his two halves accidentally each got sent to two different hospitals on 1,000 Ways To Die show on Spike TV. He was conscious, screaming, and survived for a few hours.
This recent New Scientist article references the use of paracetamol (acetaminophen) to block rhabdomyolysis products produced by crush injuries from destroying the kidneys.
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I put that link in a spoiler tag, not because it’s overly graphic, but because it’s extremely real, and I got some reports from people that were bothered by the video.
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