Rhabdomyolysis after Prolonged Suspension in a Cave

A 29-year-old man was caving and could not ascend his rope. He was rescued after 4+ hours of hanging after which he could not feel his legs and could not move one of them. He was shivering but still alert. In the field, he received calcium chloride, normal saline, and bicarbonate. At the hospital, he was found to have elevated creatine phosphokinase levels that resolved after continued intravenous fluid. Suspension trauma can include early syncope and late rhabdomyolysis. Persons suspended passively must be rescued immediately and given intravenous fluid to prevent rhabdomyolysis and renal failure.