Difference between revisions of "Crush syndrome"
(→Prehospital Proticol for Entrapment Lasting >4hrs or Suspicion of Hyperkalemia) |
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| Line 24: | Line 24: | ||
**Sodium Bicarbonate | **Sodium Bicarbonate | ||
***Flush IV with NS (prevent precipitation), then | ***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 | **Release compression | ||
Revision as of 16:12, 3 October 2013
Contents
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
- Hyperkalemia
- Hyperphosphatemia
- Hypocalcemia
- Rhabdo and renal failure
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