If present it should be treated with fasciotomy. Fasciotomies should not be performed if the compartment syndrome has been present for > 24 hours. Open wounds should be treated with antibiotics, tetanus toxoid and debridement of necrotic tissue. [cancertherapyadvisor.com]

Rhabdomyolysis classically presents with myalgia, generalized weakness, and darkened urine (myoglobinuria). Complications include acute kidney injury and crush syndrome, the systemic manifestation of traumatic rhabdomyolysis. [amboss.com]

Their patient presented following a crush injury to the posterior thigh while at work. He had extensive bruising along the distal posterior-medial thigh. [med.emory.edu]

Presentation Left hand crushed by boulder. Open wounds to dorsum over MCPJs and index PIPJ. Patient Data Age: Adult Gender: Female Loading images... Comminuted fractures of left index, middle and ring finger proximal phalanxes. [radiopaedia.org]

Gluteal CS is difficult to diagnose, as peripheral pulses will be present despite the increase in the compartment pressure and, besides, the other injuries that are present tend to divert the attention of the treating physician. [ncbi.nlm.nih.gov]

• Gangrene

  […] myoglobinuria Infection: CMV, EBV, adenovirus, Streptococcus pneumoniae, bacteremia, hepatitis, influenza/coxsackie viruses, shigellosis, salmonellosis, gram-negative septic shock, Legionella, leptospirosis, Rocky Mountain spotted fever, trichinosis, tetanus, gangrene [anesth.unboundmedicine.com]

  Physiological disorders Compartment syndrome Paralysis of the crushed limb Amputation to prevent gangrene or death Why Crush Injuries Are Dangerous & Potentially Fatal When a crush injury occurs, abnormal compression forces disrupt the normal chemical [arnolditkin.com]

  By trying to preserve the limb, doctors run the risk of infection, gangrene and rhabdomyolysis. "Removing a limb could mean saving a life," he said. [edition.cnn.com]

  Bell E: Arthrosclerotic gangrene of the lower extremities in diabetic and non-diabetic persons. Am J Clin Path 28:27, 1957. 34. Entin M: Roller and wringer injuries: clinical and experimental studies. Plast Reconstr Surg 15: 290-312, 1955. 35. [podiatrytoday.com]

• Muscle Swelling

  Crush Injury: Compression of extremities or other parts of the body that causes muscle swelling and/or neurological disturbances. Crush Syndrome: Crush injury with systemic manifestations. [cancertherapyadvisor.com]

• Foot Drop

  He is being followed in the orthopedic outpatient clinic and is receiving physiotherapy for the right-sided foot drop. [ncbi.nlm.nih.gov]

• Unable to Walk

  He was given adequate analgesia and was taking a normal diet but the weakness and pain in both lower limbs persisted and he was unable to walk. Electromyography (EMG) on day 16 showed bilateral sciatic nerve injury. [ncbi.nlm.nih.gov]

• Oliguria

  It was found that removal of the extremity from the press after five hours was followed by swelling of the thigh, an increase in the concentration of the blood, a decline in blood pressure, oliguria, abnormal urinary findings, elevated blood creatine [jamanetwork.com]

  Malignant hyperthermia References: [2] [3] Pathophysiology Clinical features Rhabdomyolysis Classic triad Myalgia Generalized weakness Darkened urine (red to brown) Nonspecific symptoms : fever ;, nausea, vomiting Complications Acute kidney injury : oliguria [amboss.com]

  Dialysis and Hemofiltration Oliguria or anuria responsive to treatment, fluid therapy, volume overload, and a rising serum potassium (47 mEq/L) are indicators of the need for dialysis. [cancertherapyadvisor.com]

  The appearance, duration and gravity of oliguria and kidney damage are not related to the severity of muscle damage [ 6 ]. The muscles are grossly swollen, hard, cold, insensitive and necrotic. [ncbi.nlm.nih.gov]

  There may be oliguria with profound hypovolaemic shock. Nausea, vomiting, confusion and agitation may occur as consequences of disturbed body chemistry; urea, creatinine, uric acid, potassium, phosphate and creatine kinase are elevated. [patient.info]

• Dark Urine

  Patients have vague symptoms like swollen extremities and muscle weakness, but one glaring indicator of kidney trouble is the dark, cola-colored urine. [edition.cnn.com]

• Narrow QRS Complex

  Your initial ECG is sinus tachycardia with narrow QRS complexes and unremarkable T waves. You give an additional dose of fentanyl and you signal rescue to free the patient’s limb. [jems.com]

• Pseudomonas

  Microbiology cultures from the abrasion showed pseudomonas and Bacteroides fragilis and, accordingly, the antibiotic was changed to meropenem. He remained febrile. [ncbi.nlm.nih.gov]

• Streptococcus Pneumoniae

  pneumoniae, bacteremia, hepatitis, influenza/coxsackie viruses, shigellosis, salmonellosis, gram-negative septic shock, Legionella, leptospirosis, Rocky Mountain spotted fever, trichinosis, tetanus, gangrene, HIV W/ history of trauma, maintain high index [anesth.unboundmedicine.com]

[…] hyperbaric treatment (21% O2 at 1.1 ATA, identical treatment schedule). [ddrc.org]

Treatment- Firstly, any wounds that are present will need to be cleaned and bandaged to prevent infection. Treatments for a foot crush injury may also include medication, casting, kinesiology taping, ice and heat, physical therapy, or surgery. [lakeridgefootankle.com]

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. [pennstatehershey.adam.com]

Treatment There is no pre-hospital treatment of Compartment Syndrome - recognition is important for communicating to the recieving hospital. [realfirstaid.co.uk]

Prognosis Crush injuries have a high death rate. They are associated with multi-organ damage at times that may not be reversible. Function of the injured muscle should return if the tissue did not die. [pagelaw.com]

If levels continue to elevate, consider ongoing muscle injury or compartment syndrome. [ 11 ] Prognosis Adequate fluid support improves prognosis. [ 12 ] The mortality rate for crush syndrome following the earthquake in northern Turkey in 1999 was 15.2% [patient.info]

Prognosis Crushed torso – Increases mortality rates Presence of ‘lethal triad of trauma’ (acidosis, coagulopathy, hypothermia) -Increases mortality rates Development of ARF (urine output 40 mg/dL and creatinine >200 mmol/L) -Increases mortality rates [cancertherapyadvisor.com]

Due to the limited parameters we could obtain, observation of urine output served as an important parameter for diagnosis of patients and for predication of prognosis. [ccforum.biomedcentral.com]

A clean cut injury to the nerve has a better prognosis than crush injuries, which are better than avulsions. If the wound is contaminated or there is a wide gap, it is better to perform delayed nerve grafting. [intechopen.com]

Definition Etiology Causes of rhabdomyolysis Traumatic Crush injury Direct injury Nontraumatic Seizures Overexertion (e.g., ultramarathon) Intoxication (e.g., cocaine, heroin, alcohol, carbon monoxide, phencyclidine ) Skeletal muscle ischemia Infection [amboss.com]

Etiology/ common causes 1.Drug overdose: trunk compression of forearm and leg. 2.Surgical knee chest position: compression of leg anterior compartment. 3.Crushing industrial accidents. [youtube.com]

After studying the information presented here, you will be able to: List common etiologies of crush injuries Define crush injury, compartment syndrome, and crush syndrome Describe manifestations that accompany compartment syndrome and crush syndrome List [nurse.com]

This article reviews the epidemiology, pathophysiology, diagnosis, and early management of crush syndrome. [nursingcenter.com]

Epidemiology Crush syndrome has been described in numerous settings, most commonly after earthquakes, during war and after explosions that have caused buildings to collapse. [patient.info]

Epidemiology Rhabdomyolysis occurs in up to 85% of patients with traumatic injuries. 10–50% of patients with rhabdomyolysis develop ARF. Patients with rhabdomyolysis-induced renal failure have a mortality of approximately 20%. [cancertherapyadvisor.com]

A common pathophysiological pathway has been elucidated over the last century describing traumatic rhabdomyolysis leading to myoglobinuric acute renal failure and a systemic ‘crush syndrome’ affecting many organ systems. [semanticscholar.org]

Explore these free sample topics: -- The first section of this topic is shown below -- First Things First (assess & treat for the following) Rhabdomyolysis is a constellation of pathophysiologic changes resulting from injury to skeletal muscle w/ the [anesth.unboundmedicine.com]

(April/June 2007) Crush Injuries: Pathophysiology and Current Treatment. Advanced Emergency Nursing Journal, Volume 29 (2), 145 – 150. Barbera, J. A., & MacIntyre, A. (1996). Urban search and rescue. [limmereducation.com]

Pathophysiology [ edit ] Crush injury is damage to the body as a result of being crushed by an object. [en.wikipedia.org]

Seizures Overexertion (e.g., ultramarathon) Intoxication (e.g., cocaine, heroin, alcohol, carbon monoxide, phencyclidine ) Skeletal muscle ischemia Infection Adverse drug reactions (e.g., neuroleptics, statins ) Malignant hyperthermia References: [2] [3] Pathophysiology [amboss.com]

Workers must be trained in the proper methods of operation, cleaning, and maintenance of the equipment to prevent crushing injury. [arnolditkin.com]

[…] of muscle tissue & influx of myoglobin, potassium, and phosphorus into the circulation; - syndrome is characterized by hypovolemic shock and hyperkalemia ; - these results strongly suggest that free-radical scavengers are beneficial in attenuating or preventing [wheelessonline.com]

Early resuscitation is imperative to prevent hypovolemia and cardiac dysrhythmias. [jems.com]

It also prevents neutrophil adhesion and prevents secondary injury. It is directly bactericidal to anaerobic organisms. [cancertherapyadvisor.com]

Kidney failure has been identified by the Centers for Disease Control and Prevention as one of the most urgent public health concerns in Haiti following the 7.0-magnitude earthquake. [edition.cnn.com]