What is Crush Injury Syndrome?
Crush injuries are most common in areas where there are earthquakes. We have all heard of people being in buildings when an earthquake happened, and they become crushed under the weight of the debris of the fallen building. Crush injuries also happen in horrific traffic accidents. When a person sustains a horrific crush injury, a condition known as crush syndrome occurs. The kidneys begin to shut down due to blood loss and loss of bodily fluids. With crushing injuries, a crushed torso almost always will lead to the death of the victim due multiple organ systems failing at the same time. With crush injuries a large portion of the body will sustain so much pressure exerted on the soft tissues that the muscles rupture at the cellular level and spill their contents. The blood vessels also collapse and rupture and the flow of blood cease to circulate through the body. Here is the life and death problem with crush injuries: The muscles rupture and release potassium and a protein called myoglobin. Potassium and myoglobin are deadly to the body when circulation to the body is restored. Too much potassium in the blood causes a condition called hyperkalemia which can stop the heart. The myoglobin in the blood is the other culprit because it is a protein that will shut down the kidneys.
Crush injuries are fairly common, especially in areas where earthquakes are commonplace. When EMTs get on the scene they will start IV fluids to treat shock and loss of blood and bodily fluids (hypovolemia). Crush syndrome protocol may vary with the situation. For instance, if a crush victim is sitting up, do not lay them down when you start IV fluids. The patient could go into shock.
A person who has sustained a crush injury will be in terrible pain. The victim will quickly go into shock. The symptoms of shock due to a crush injury are pale skin color, paresthesia (numbness, pain, burning of the nerve endings), skin may be cool to touch, and there may be paralysis of a limb.
If a crush victim has an entrapped limb, you may or may not use a tourniquet depending on the situation. If a tourniquet is used, it should not be put on tightly unless there is hemorrhaging. Crush syndrome victims are crushed when heavy debris or machinery has fallen on them or trapped them in some way to cause extreme continuous pressure on the body or part of the body. The goal in rescuing a person with crush syndrome is to prevent kidney and heart failure. For more information about crush injury protocol, click here.
Image credit of crushed truck - Google for commercial use