A 28-Year-Old Man Is Brought to the Emergency Department Due

A 28-year-old man is brought to the emergency department due to a construction site accident in which a heavy concrete slab fell on his legs.  The patient was trapped from the waist down for about 15 minutes until other workers were able to rescue him.  He sustained no injury to the head or upper torso and did not lose consciousness.  The patient has no significant medical history and takes no medications.  He drinks 1 or 2 beers daily but does not use tobacco or illicit drugs.  Blood pressure is 140/90 mm Hg, and pulse is 110/min.  Bilateral breath sounds are equal and normal.  Heart sounds are not muffled.  The abdomen is soft and nontender.  There are obvious deformities, abrasions, and lacerations on both lower limbs.  Radiographs reveal multiple bilateral lower extremity fractures.  After the patient is cleared of other major trauma, he is taken for surgical stabilization and fixation of the lower extremity fractures.  Succinylcholine is considered for rapid-sequence intubation.  With the use of succinylcholine, this patient is at greatest risk for which of the following?

A) Acute liver failure due to toxic drug intermediaries
B) Adrenal insufficiency due to 11β-hydroxylase inhibition
C) Cardiac arrhythmia due to electrolyte derangement
D) Neurotoxicity due to methionine synthase inhibition
E) Severe hypotension due to myocardial depression

Correct Answer:

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