Crush Injury

A crush injury occurs when a body part is subjected to a significant amount of force or pressure, usually from being squeezed between two heavy objects or being crushed under a heavy object. This type of injury can lead to varying degrees of damage to muscles, nerves, blood vessels, and bones.

Crush injuries may result from a variety of situations, including vehicle entrapment, falling debris, industrial accidents or by prolonged pressure to a part of the body due to their own body weight in an immobile person.

Recognition

• A crush injury should be suspected whenever a part of the body is crushed or compressed or when you are unable to fully see or examine a part of the body.
• Crush injury can also result from prolonged pressure to a part of the body due to their own body weight in an immobile person and may show few symptoms or signs.
• Persons with crush injuries may show symptoms and signs of bleeding, shock, and hypothermia.
• A person with a crush injury may not complain of pain and there may be no external signs of injury.
  

  

First aid

• Ensure your safety and the safety of others.
• Call an ambulance.
• If it is safe to do so and physically possible, remove all crushing forces from the person as soon as possible.
• Control any external bleeding.
• Treat any other injuries (i.e. fractures, dislocations).
• Keep them warm and maintain body temperature.
• Reassess and monitor for deterioration.

Use of tourniquets: There is insufficient evidence to recommend the routine use of a tourniquet prior to the release of a crushing force to delay the onset of reperfusion injury. The application of a tourniquet is recommended where there is life-threatening bleeding from a limb before or immediately following the removal of the crushing force. Bleeding may be significant following the release of a crushing force. A tourniquet may be put into position prior to the release of the crushing force in anticipation of life-threatening bleeding but this should not delay the release of the crushed person.

Crush syndrome

• Crush syndrome refers to the multiple problems that may subsequently develop, most commonly as a result of crush injuries to the limbs, particularly the legs.
• Crush syndrome results from disruption of the body’s chemistry and can result in kidney, heart and other problems.
• The likelihood of developing acute crush syndrome is directly related to the compression time, therefore crushed persons should be released as quickly as possible, irrespective of how long they have been trapped.