Crush syndrome: Difference between revisions
Line 5: | Line 5: | ||
===Pathophysiology=== | ===Pathophysiology=== | ||
*[[ | *Hypovolemic [[shock]] | ||
**Third spacing of fluids | **Third spacing of fluids | ||
*[[Metabolic acidosis]] | *[[Metabolic acidosis]] |
Revision as of 06:32, 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
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.