Crush syndrome: Difference between revisions
| Line 8: | Line 8: | ||
**Third spacing of fluids | **Third spacing of fluids | ||
*Metabolic acidosis | *Metabolic acidosis | ||
**Hyperkalemia | **[[Hyperkalemia]] | ||
**Hyperphosphatemia | **[[Hyperphosphatemia]] | ||
**Hypocalcemia | **[[Hypocalcemia]] | ||
**Rhabdo and | **[[Rhabdo]] and [[Renal Failure]] | ||
==Management== | ==Management== | ||
Revision as of 16:15, 3 October 2013
Background
- >4-6 hours to develop
- Rare cases with severe compression can develop <1 hr
- Starts after blood flow is restored
Pathophysiology
- Cardiovascular shock
- Third spacing of fluids
- Metabolic acidosis
Management
Prehospital Proticol for Entrapment Lasting >4hrs or Suspicion of Hyperkalemia
- Should begin BEFORE extrication
- Cardiac monitoring
- Hydration (~NS 1.5 L/hr)
- Pain control
- Albuterol neb
- Calcium Chloride
- 1 gram slow IV push over 60 sec
- Sodium Bicarbonate
- Flush IV with NS (prevent precipitation), then
- 1mEq/kg added to 1L of normal saline, run IV wide open just prior to extrication
- Release compression