Crush syndrome: Difference between revisions

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==Management==
==Management==
===Prehospital Proticol for Entrapment Lasting >4hrs or Suspicion of [[Hyperkalemia]]===
===Prehospital Proticol for Entrapment Lasting >4hrs or Suspicion of [[Hyperkalemia]]===
*Should begin BEFORE extrication
''Should begin BEFORE extrication''
**Cardiac monitoring
*Cardiac monitoring
**Hydration (~NS 1.5 L/hr)
*Hydration (~NS 1.5 L/hr)
**Pain control
*Pain control
**Albuterol neb
*[[Albuterol]] neb
**Calcium Chloride
*[[Calcium chloride]]
***1 gram slow IV push over 60 sec
**1 gram slow IV push over 60 sec
**Sodium Bicarbonate
*[[Sodium bicarbonate]]
***Flush IV with NS (prevent precipitation), then
**Flush IV with NS (prevent precipitation), then
***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