Crush syndrome: Difference between revisions
No edit summary |
|||
| Line 12: | Line 12: | ||
**[[Hypocalcemia]] | **[[Hypocalcemia]] | ||
**[[Rhabdo]] and [[Renal Failure]] | **[[Rhabdo]] and [[Renal Failure]] | ||
==Clinical Features== | |||
==Differential Diagnosis== | |||
==Diagnosis== | |||
==Management== | ==Management== | ||
| Line 27: | Line 33: | ||
**Release compression | **Release compression | ||
*In the field, use of tourniquet before extrication is controversial. | *In the field, use of tourniquet before extrication is controversial. | ||
==Disposition== | |||
==See Also== | ==See Also== | ||
Revision as of 06:33, 13 September 2015
Background
- >4-6 hours to develop
- Rare cases with severe compression can develop <1 hr
- Starts after blood flow is restored
Pathophysiology
- Hypovolemic shock
- Third spacing of fluids
- Metabolic acidosis
Clinical Features
Differential Diagnosis
Diagnosis
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
- In the field, use of tourniquet before extrication is controversial.