Managing the Toxic Chemical Release that Occurs During a Crush Injury

You’re called to the scene of a large structure that collapsed from an accident during demolition. Upon arrival, you’re informed there are multiple casualties in the house, and fire and rescue crews are extricating patients as safely and quickly as possible. You’re notified of a patient trapped with a large metal beam resting on his left femur. Fire and rescue crews are carefully stabilizing the surrounding support structures and estimate extrication of the patient to be prolonged. The patient is alert, able to talk to rescue crew members, and reports no other complaints outside of his severe left leg pain. You prepare for his extraction by considering any potential orthopedic trauma to the patient’s left leg, as well as how to manage his crush injury and the associated toxin release you know can occur. Crush Syndrome Crush syndrome is a medical condition characterized by significant systemic symptoms resulting from toxins released by crushed muscle tissue. Crush injuries are commonly seen in severe trauma, and include direct soft tissue destruction, bony injury and limb ischemia. Up to 40% of multistory building collapse survivors suffer from crush syndrome. And it’s important to note that crush-induced rhabdomyolysis is the most frequent cause of death after earthquakes, apart from direct trauma.1 Typically, release of toxins occurs when reperfusion of the injured area is delayed for 4–6 hours. However, depending on the severity of injury and degree of compressi...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Trauma Exclusive Articles Source Type: news