A T2 Translational Science Modified Delphi Study: The Ethical Triage and Treatment of Entrapped and Mangled Extremities in Resource-Scarce Environments.

Background: There is a lack of ethical triage and treatment guidelines for the entrapped and mangled extremity (E&ME) in resource-scarce environments (RSE): mass casualty incidents, low- to middle-income countries, complex humanitarian emergencies including conflict, and prolonged transport times (RSE). The aim of this study is to use a modified Delphi (mD) approach to produce statements to develop treatment guidelines of the E&ME in RSE.

Method: Experts rated their agreement with each statement on a 7-point linear numeric scale.

Renal failure in a patient with postpolio syndrome and a normal creatinine level.

Patients with renal failure who are taking trimethoprim have an increased risk of developing hyperkalemia, which can cause muscle weakness. In patients with postpolio syndrome, a normal creatinine level could be abnormally high, renal failure is possible because of lack of creatinine production, and the muscle weakness from resultant hyperkalemia could be more severe because of their underlying condition. This abnormally high creatinine level has been termed from this point relative renal failure.