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]

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]

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]

[…] as any soft tissue or bone injury and all except pain are present only in late stages, by which time the affected limb is no longer viable. (23,24) Statistical analysis of clinical findings suggest that one indicator has a low threshold, as little as [realfirstaid.co.uk]

• 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]

• Flushing

  Treatment consists of massive quantities of IV fluids to help flush the cellular waste from the blood stream. Other supportive measures such as oxygen, blood transfusion, pain medication, etc may also be given. [pagelaw.com]

  If not hydrated regularly, the person is unable to flush out the myoglobin. [edition.cnn.com]

• Leg Pain

  The patient is alert, able to talk to rescue crew members, and reports no other complaints outside of his severe left leg pain. [jems.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]

  ARF is defined when a patient with crush injury has one of the following symptoms: oliguria (urine output 400 ml/24 hours), increases of BUN ( 40 mg/dl), serum creatinine ( 2 mg/dl), uric acid ( 8 mg/dl), potassium ( 6 mmol/l), phosphorus ( 8 mg/dl), [ccforum.biomedcentral.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]

• Dark Urine

  The victims developed dark urine and subsequently died of kidney failure. People usually develop rhabdomyolysis after crush injuries, produced by events such as earthquakes, mine collapses, traffic accidents and severe beatings. [edition.cnn.com]

• Hyponatremia

  […] palmitoyltransferase deficiency, phosphoglycerate mutase deficiency, myoadenylate deaminase deficiency, DKA, nonketotic hyperosmolar coma, hyperthyroidism/hypothyroidism, sickle cell trait Electrolyte deficiency: hypokalemia, hypophosphatemia, hypomagnesemia, severe hyponatremia [anesth.unboundmedicine.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. [iowafoot.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 Physiological [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]

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]

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]

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]

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

We determine the pathophysiology, clinical and prognostic indicators and treatment options such as forced alkaline diuresis, mannitol therapy, dialysis and haemofiltration. [journals.sagepub.com]

Crush Injury, Compartment Syndrome and Acute Traumatic Ischaemias Acute Traumatic Ischaemias, of which Crush Injury and Compartment Syndrome (below) are examples, share a common pathophysiology. [ddrc.org]

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

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

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]