Emergency Responses and Disaster Preparedness
Crush Syndrome
Crush injury occurs when heavy objects exert pressure on skeletal muscle, leading to rhabdomyolysis.
Pathophysiology
- Compression releases myoglobin and potassium into circulation.
- Myoglobin causes acute tubular necrosis and kidney failure.
- Hyperkalemia is the most immediate life-threatening concern.
Nursing Management
- Aggressive IV fluid hydration before and after releasing the limb.
- Monitor EKG for peaked T-waves or other hyperkalemia signs.
- Administer sodium bicarbonate to alkalinize urine and prevent myoglobin deposition.
- Assess for compartment syndrome distal to the crush site.
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