Difference between revisions of "Crush syndrome"

(Prehospital Proticol for Entrapment Lasting >4hrs or Suspicion of Hyperkalemia)
(See Also)
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==See Also==
 
==See Also==
 
+
*[[Compartment Syndrome]]
 +
*[[Rhabdomyolysis]]
 +
*[[Disseminated Intravascular Coagulation (DIC)]]
  
 
[[Category: EMS]]
 
[[Category: EMS]]
 
[[Category: Trauma]]
 
[[Category: Trauma]]

Revision as of 16:14, 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
    • 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

See Also