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
- Cardiomyopathy
- Cardiovascular instability
- Tubular obstruction
- Hypothermia
- Skin injury and swelling
- Metabolic acidosis with lactic acidosis
- Acute lung injury
- Loss of pulses or faint pulses
- Myoglobinuria
- 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.
Crush Injury Syndrome
Crush injury syndrome is a medical term that describes the destruction of muscle tissue or a body part after direct trauma, injury, or compression.
Crush injury often happens when a part of the body is compressed or squeezed between two heavy objects. It usually occurs from vehicle accidents or fall of heavy objects on a body part.
Crush Injury Recovery Time
The recovery time for a crush injury depends on the severity of the injury. Minor crush injuries can take 6-10 weeks of treatment until patients begin to recover. Major crush injuries can take multiple months of recovery with a comprehensive treatment plan.
Crush Injury vs Crush Syndrome
Crush syndrome is a medical condition that is characterized by kidney failure, major shock and other issues after a crush injury.
Management of Crush Injury
Crush injuries are usually emergency treatments. A patient with a crushed injury should be quickly evacuated and taken to the emergency department in a hospital.
Crush injuries usually require a comprehensive treatment plan, starting with first aid.
Steps for first aid treatment include:
- Remove the affected body part from the crushed site
- Apply direct pressure to the crushed body part to stop bleeding.
- Cover the crushed body part with a wet cloth or bandage and gently raise the area above the heart level, if possible.
The first aid helps to keep the patient alive and out of danger before being transported to the hospital for proper treatment.
Patients with crush injuries are usually taken to the emergency department where they receive comprehensive treatments that include surgery, medications, orthopedic evaluation and bone amendments, and physical therapy.
Crush Syndrome Symptoms
Symptoms of crush injury syndrome include:
- Bleeding
- Bruising
- Broken bone or fracture
- Open wound
- Muscle damage
- Nerve injury
- Tissue damage
- Blood vessel damage
- Infection caused by bacteria that gets into the body through the open wound
Crush Injury Lower Leg
The lower leg is a common part of the body that is prone to crush injury. Crush injury to the lower leg can result in broken or fractured bone, muscle damage, tissue damage, nerve injury, bleeding, open wound, etc.
How to Prevent Crush Syndrome
- Drive carefully to prevent accidents
- Regularly check and maintain your machinery.
- Follow all safety precautions at work
- Be very careful when you’re in an area prone to accidents.
