EM@3AM: Crush Injury
A 17-year-old girl, in moderate distress, is brought in by EMS after a motor vehicle collision. EMS reports that she was “pinned” underneath the dashboard, and it took several hours to extricate her. Triage vital signs significant for BP 103/69, HR 99, SpO2 99% on 2 L NC, RR 25, Temp 98.6. She has normal mental status but is in distress with severe pain in her legs. On exam she has erythema, ecchymosis, and gross deformities to bilateral lower extremities but intact distal sensation and palpable pulses. She refuses to move her legs secondary to pain. Laboratory testing reveals elevated potassium and CK. What is the diagnosis?
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