Crush syndrome: Difference between revisions

No edit summary
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**[[Hypocalcemia]]
**[[Hypocalcemia]]
**[[Rhabdo]] and [[Renal Failure]]
**[[Rhabdo]] and [[Renal Failure]]
==Clinical Features==
==Differential Diagnosis==
==Diagnosis==


==Management==
==Management==
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**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==


==See Also==
==See Also==

Revision as of 06:33, 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