Crush and Compartment Syndrome

Question 1

Rhabdomyolysis

Answer 1

acute disease characterised by destruction of skeletal muscle, resulting in substances passing into the bloodstream and affecting the kidneys

Question 2

Weight on limb causes

Answer 2

oedema
increased compartment pressure - tamponade
damaged cell tissue enters the systemic circulation - damaging organs

Question 3

Pathophys of rhabdomyolysis

Answer 3

occurs in episodes of excessive muscular activity, increased exercise leads to the exhaustion of cellular ATP reserves which results in disruption of cell membrane therefore muscle cells degranulate and enter circulation

Question 4

Crush Injury

Answer 4

injury from exposure of tissue to a compressive force sufficient to interfere with normal structure and metabolic function for the involved cells and tissues
degree of injury depends on pressure, time and region

Question 5

Compartment Syndrome

Answer 5

a pathological condition caused by progressive development of arterial compression and reduced blood supply secondary to increased pressure within the compartment
results of crush injury
pressure in closed fascial compartment

Question 6

Signs and symptoms of compartment syndrome

Answer 6

vascular insufficiency, pain, paresis, parasthesia, pallor, pulselessness, pain disproportionate to injury, swelling, tenderness to palpate, weakness of the muscle group, pain on passive stretching

Question 7

Crush Syndrome

Answer 7

systemic manifestation of major shock and renal failure secondary to rhabdymyolysis caused by prolonged continuous pressure on muscle tissue

Question 8

Criteria for Crush Syndrome

Answer 8

crushing injury to a large mass of skeletal muscle, sensory and motor disturbances in the compressed limbs, myoglobinuria and/or haematuria, peak creatine kinase normal

Question 9

Acute Renal Failure

Answer 9

sudden onset of impaired ability to excrete wastes due to large myoglobin molecules get stuck in the mslal tubules of the nephrons

Question 10

Treatment of Crush syndrome

Answer 10

consider fractures, shock, spinal, organ damage
O2 therapy
IV access
Fluid: normal saline 1-1.5 L during extrication