Difference between revisions of "Crush syndrome"

(Management)
(Management)
Line 32: Line 32:
 
**1mEq/kg added to 1L of normal saline, run IV wide open just prior to extrication
 
**1mEq/kg added to 1L of normal saline, run IV wide open just prior to extrication
 
*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==
 
==Disposition==

Revision as of 06:34, 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

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

Disposition

See Also

References