Difference between revisions of "Crush syndrome"

(Differential Diagnosis)
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==Background==
 
==Background==
*>4-6 hours to develop
+
===Criteria==
**Rare cases with severe compression can develop <1 hr
+
#Involvement of muscle mass
*Starts after blood flow is restored
+
#Prolonged compression of 4-6 hours but possible in <1 hr
 +
#Compromised local circulation
  
 
===Pathophysiology===
 
===Pathophysiology===

Revision as of 17:18, 26 December 2015

Background

=Criteria

  1. Involvement of muscle mass
  2. Prolonged compression of 4-6 hours but possible in <1 hr
  3. Compromised local circulation

Pathophysiology

Clinical Features

Differential Diagnosis

Extremity trauma

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