Crush Injury/Syndrome
Crush injuries can occur in different settings such as collapsed buildings, in the industrial setting or can be seen in road traffic accidents. Crush injury results in muscle disintegration due to prolonged pressure on large muscles.
Crush syndrome occurs due to a reperfusion of muscle tissue which in turn causes rhabdomyolysis. Rhabdomyolysis develops when muscle tissue has prolonged pressure applied to it and the tissue begins to breakdown and release damaging chemicals into the bloodstream
Signs and Symptoms
- There may or may not be any signs and symptoms
- Be suspicious of any patient that has had a large structure trapped for a period of time
- Tight skin around an extremity
- 5 P's
- Pain
- Poikilothermy (body temperature that varies with that of the environment) - cold skin
- Pallor
- Pulselessness (Distal)
- Paresthesia
General Management Techniques
Request for paramedic backup at earliest opportunity as an IV sodium chloride solution should be started before extrication from the accident. Early hydration will help prevent renal collapse
Continually monitor patient condition
Consider an ASHICE
Smooth and rapid journey to hospital
Professional handover to hospital staff
Further Reading
Beyond the Basics: Crush Injuries and Compartment Syndrome