A crush injury occurs when a great force or pressure is applied to a body part. It is an injury that occurs when a body part is squeezed between two heavy objects.
Crush injuries are associated with major fractures, rupture of internal organs, wounds and hemorrhagic shock. Early treatment and immediate first aid treatment is required for individuals with crush injuries.
The severity of the soft tissue damage and fractures pose a major concern to the survival chances of a patient. Prolonged compression of a body part may lead to a fatal condition known as Crush syndrome.
Causes of Crush Injury
Crush injuries are commonly caused by fatal accidents and catastrophes.
Other causes include:
- Hands and fingers getting jammed in doors or windows
- Fall from a height
- Sports-related injuries
- Car accidents
- Building collapse
- Occupational hazards in working environments
- Dropping of heavy objects on the leg or other body parts
Symptoms of Crush Injuries
The signs and symptoms of crush injuries include:
- Renal failure
- Hypotension and hypovolemic shock
- Cardiovascular instability
- Tubular obstruction
- Skin injury and swelling
- Metabolic acidosis with lactic acidosis
- Acute lung injury
- Loss of pulses or faint pulses
- Disseminated intravascular coagulopathy
- Compartment syndrome
- Paralysis and paresthesia
- Bone fractures
- Loss of consciousness
- Severe pain
- Severe bleeding
First Aid treatment for Crush Injury
Before a patient with a crush injury is transported to the hospital for treatment, first aid treatment is mostly required. First aid treatment stops excess bleeding and reduces severe damages or fatality.
First aid treatment tips for crush injuries include:
- If the patient was involved in a car accident
- Stop excess bleeding by applying direct pressure to the injury site.
- Cover up the injury area with a wet cloth or bandage.
- Raise the area above the heart if possible.
- If there is suspicion of spinal injury or dislocation, limit movements to the area.
- Call your local emergency number for further treatment.
- If the patient was trapped between two objects
- Carefully try to remove the patient from the trapped site to a safe area.
- Stop excess bleeding by applying pressure to the injury site.
- If the muscle or bone have been compressed, limit movement to the compressed area so as not to cause more damages.
- Keep the patient calm and still.
- Call your local emergency number for a prompt response and further treatment.
- For minor cases of crush injuries
- Clean the injury area with water or a clean cloth
- Apply pressure in case of bleeding
- Apply the ice pack to the injury site to reduce pain and swelling. The ice pack should be wrapped in a cloth or towel.
- If there is any fracture, limit movement to the area.
- Call your local emergency number for immediate further treatment.
When an individual is involved in an accident and is suffering from a crush injury, immediate treatment is required.
When a part of the body is compressed, several things start to go wrong in the body system. These include:
- The cells around the crushed area start to get damaged very quickly.
- Within the next hour, the pressure continually decreases the circulation of blood to the area.
- The cells around the crushed area begin to leak and die. The contents of the cells which include potassium, myoglobin, purines and other toxic substances begin to leak out of the cells to the surrounding tissues. If this is not resolved as quickly as possible, it could lead to other severe issues and could lead to the death of the patient.
- The heavy material exerting the pressure on the part of the patient’s body should be quickly removed. When it is removed, the weight is released and blood begins to flow. When the heavy material is not removed on time and treatment is not done on time, it could lead to arrhythmias, kidney failure, liver damage, cardiac arrest, or other body system failures.
- A conscious patient may deteriorate very quickly depending on the amounts of toxins and chemicals that are released and spread all over the body.
Treatment of Crush Injuries
The treatment of a crush injury is similar to the treatment of severe trauma in most patients.
After the first aid treatment, the patient should be immediately transferred to the hospital for intensive care and further treatment.
The things that may need to be done include:
- If there are any broken materials hanging inside the skin or body of the patient, they should be carefully taken out.
- The patient should be given high concentration oxygen if he/she is hypoxic.
- All parts of the body of the patient should be thoroughly accessed, especially the crush injury site.
- Intravenous or intraosseous access should be established, especially before the removal of the object causing the compression.
- Normal saline fluid infusion should be immediately administered to the patient. Fluids that contain potassium should be avoided. This is due to the risk of rhabdomyolysis-associated hyperkalemia.
Fluids that contain potassium may worsen the condition of the patient as there is already a high level of potassium in the bloodstream of the patient.
- A baseline ECG strip and subsequent strips should be conducted. These strips may be transferred to the site of the trauma or injury. The ECG stripes can help to ascertain the level and changes in hyperkalemia.
- For life-threatening suspected hyperkalemia, calcium chloride may be administered to the patient.
- The patient can be treated for pain depending on the medical direction and if the patient is going through a great deal of pain.
- Aerosolized albuterol may also be administered depending on the medical direction.
- The patient should be accessed for other injuries.
- In the case of fracture or dislocation, the bones should be carefully aligned and may require the medical care of a bone specialist.
Prevention of Crush Injury
Crush injury is generally caused by accidental occurrences. There are several preventive measures an individual can take to prevent crush injury. These include:
- Children playing at parks and playgrounds should be carefully supervised.
- Drive carefully to avoid accidents.
- Use seatbelts and follow all safety rules when driving.
- Use personal protective equipment while performing certain sports or outdoor activities.
- Follow all safety measures and always put on protective clothing and shoes when working in a hostile working environment.
- Avoid places that are prone to accidents.
- Be very careful when climbing up and down the staircase or a height.