Crush Syndrome: A Case Report and Review of the Literature
Crush Syndrome: A Case Report and Review of the Literature
Early, aggressive resuscitation in the prehospital setting, before extrication if possible, is recommended to reduce the complications of crush syndrome. Providers must be aware of the risk of hyperkalemia shortly after extrication. Close monitoring of patients for development of shock, metabolic derangements, and rhabdomyolysis is critical. Ongoing resuscitation with i.v. fluids is the mainstay of treatment, and emergency physicians should consider early renal consultation. Compartment syndrome is a common complication, and prompt fasciotomies should be performed when compartment syndrome is present. Although no randomized studies of crush syndrome are available, observational data suggest that aggressive resuscitation and close monitoring can reduce the risk of renal failure and death.
Conclusions
Early, aggressive resuscitation in the prehospital setting, before extrication if possible, is recommended to reduce the complications of crush syndrome. Providers must be aware of the risk of hyperkalemia shortly after extrication. Close monitoring of patients for development of shock, metabolic derangements, and rhabdomyolysis is critical. Ongoing resuscitation with i.v. fluids is the mainstay of treatment, and emergency physicians should consider early renal consultation. Compartment syndrome is a common complication, and prompt fasciotomies should be performed when compartment syndrome is present. Although no randomized studies of crush syndrome are available, observational data suggest that aggressive resuscitation and close monitoring can reduce the risk of renal failure and death.