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1. In recovery, patients can have significant hypercalcemia from sec­ondary hyperparathyroidism, do not treat hypocalcemia unless it is severe or the patient is symptomatic.

2. Most recommend treatment as soon as possible with isotonic fluid resuscitation or forced diuresis with alka­linization of the urine.

3. Urine pH is raised above 6.5 to diminish the renal toxicity of heme & prevent the myoglobin-induced tubular damage.

4. Watch out for hyperkalemia. Dialysis is used in severe cases.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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