What is the recommended initial management for a patient with suspected rhabdomyolysis following an electric shock?

The recommended initial management for a patient with suspected rhabdomyolysis following an electric shock is aggressive fluid infusion. Rhabdomyolysis occurs when muscle fibers break down and release myoglobin into the bloodstream, which can cause kidney damage, electrolyte imbalances, and lead to acute kidney injury.

In cases of rhabdomyolysis, maintaining robust hydration is critical to dilute the myoglobin in the renal tubules and promote urine flow, which helps prevent the formation of casts and occlusion in the kidney. Aggressive intravenous hydration with isotonic saline is typically initiated to achieve high urine output, often targeted at over 200 mL/hour, to help protect the kidneys.

This approach addresses the primary concern of preventing acute kidney injury, which is a common complication of rhabdomyolysis, especially following electric shock injuries that tend to cause significant muscle injury. While other options, such as angiography or surgical intervention, may be relevant in certain contexts of trauma or vascular injury, they are not the first-line response in managing the metabolic consequences of rhabdomyolysis. Observation without intervention is insufficient, as prompt action is necessary to mitigate the potential complications of this condition.