RescueDigest Resources: Crush Injury, Compartment Syndrome and Suspension Trauma

RescueDigest’s Top Picks of essential resources for critical topics in emergency services.

Crush Injury, Compartment Syndrome, Suspension Trauma and Rhabdomyolysis Resources

Pinned in a car for two hours, trapped in a building collapse for 12, fallen on the floor for 24. Each of these patients may be experiencing different, but deadly aspects of crush injury, compartment syndrome, suspension trauma, and rhabdomyolysis. Why are some victims okay under pressure, but die suddenly when rescued and what, if anything, can EMS do about it? Real-world case-studies and sample prehospital protocols below will help answer these questions and more by bringing you evidence based best practices, real-world “how-to” and resources that you can use to treat these high-pressure and high-profile patients. 


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How you can use these resources: RescueDigest curates great research and resources during the development of our articles and educational programs. Since our mission is to “Help You Help Others” we present the best of these resources for you to explore, share and use in your own agency.

Please note that some of the links below, especially for the textbooks and research papers, may require paid access. Even if you do not already have direct access you should be able to gain the full information through most local and virtually all medical or research libraries. The U.S. National Fire Academy may also be helpful in obtaining these and additional resources.

Recorded free webinar of this presentation Sponsored by Fire Engineering Magazine and Zoll Medical Products.

Crush Injury (and more)

Coordinating Care for Crush Injury by Rom Duckworth

Crush syndrome made simple

Typical Crush Injuries: Trauma.org

PREHOSPITAL MANAGEMENT OF CRUSH INJURIES – Fire Engineering

 Recognizing and Treating Crush Syndrome

NAEMSP / ACEP  Review Of Crush Injuries

Life in the Fast Lane Critical Care Compendium: Crush Syndrome

Sever, M. S. (2005). The Crush Syndrome (and Lessons Learned from the Marmara Earthquake). S Karger Ag.

Wu, M. J., Lian, J. D., Lee, M. C., Chang, H. R., & Chen, C. H. (2005). Rhabdomyolysis following crush injury in the Taiwan Chi-Chi earthquake. Acta Nephrologica.

Hu, Z., Zeng, X., Fu, P., Luo, Z., Tu, Y., Liang, J., et al. (2012). Predictive factors for acute renal failure in crush injuries in the Sichuan earthquake. Injury, 43(5), 613–618. http://doi.org/10.1016/j.injury.2010.08.025

Sever, M. S., Vanholder, R., & Lameire, N. (2006). Management of Crush-Related Injuries after Disasters. New England Journal of Medicine, 354(10), 1052–1063. http://doi.org/10.1056/NEJMra054329

Yokota, J. (2005). Crush Syndrome in Disaster. Japan Medical Association Journal, 48(7), 341–352.

Gonzalez, D. (2005). Crush syndrome. Critical Care Medicine, 33(Supplement), S34–S41. http://doi.org/10.1097/01.CCM.0000151065.13564.6F

Sahjian, M., & Frakes, M. (2007). Crush Injuries. Advanced Emergency Nursing Journal, 29(2), 145–150. http://doi.org/10.1097/01.TME.0000270337.34627.02

Sahjian, M., & Frakes, M. (2007). Crush injuries: pathophysiology and current treatment. The Nurse Practitioner, 32(9), 13–18. http://doi.org/10.1097/01.NPR.0000287464.81259.8b

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Compartment Syndrome

Compartment Syndrome Versus Crush Syndrome

Beyond the Basics: Crush Injuries and Compartment Syndrome

Smith, J., & Greaves, I. (2003). Crush Injury and Crush Syndrome: A Review. Journal of Trauma and Acute Care Surgery, 54(5), S226.

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Suspension Trauma

Silver Cross EMS: Suspension Trauma: DOWNLOADABLE POWERPOINT

Auerbach, P. S. (2011). Wilderness Medicine. Elsevier Health Sciences.

Lee, C., & Porter, K. M. (2007). Suspension trauma. Emergency Medicine Journal, 24(4), 237–238.

Roggla, G., Moser, B., & Roggla, M. (2008). Re: Suspension trauma. Emergency Medicine Journal, 25(1), 59–59. http://doi.org/10.1136/emj.2007.049197

Mortimer, R. B. (2011). Risks and management of prolonged suspension in an Alpine harness. Wilderness & Environmental Medicine, 22(1), 77–86. http://doi.org/10.1016/j.wem.2010.10.008

Pasquier, M., Yersin, B., Vallotton, L., & Carron, P.-N. (2011). Clinical update: suspension trauma. Wilderness & Environmental Medicine, 22(2), 167–171. http://doi.org/10.1016/j.wem.2010.12.006

Soteras, I., Subirats, E., Clapés, A., Subirats, G., & Casadesús, J. M. (2014). [Suspension trauma: a form of positional asphyxia]. Medicina Intensiva, 38(7), 467–468. http://doi.org/10.1016/j.medin.2013.11.001 (SPANISH)

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Rhabdomyolysis

Rhabdomyolysis and the Use of Sodium Bicarbonate And/or Mannitol

Wharton, D. R., & Mortimer, R. B. (2011). Rhabdomyolysis after prolonged suspension in a cave. Wilderness & Environmental Medicine, 22(1), 52–53. http://doi.org/10.1016/j.wem.2010.12.007

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Additional Resources

Schöffl, V., Popp, D., Küpper, T., & Schöffl, I. (2015). Injury Trends in Rock Climbers: Evaluation of a Case Series of 911 Injuries Between 2009 and 2012. Wilderness & Environmental Medicine, 26(1), 62–67. http://doi.org/10.1016/j.wem.2014.08.013

Burns, K., Cone, D. C., & Portereiko, J. V. (2010). Complex extrication and crush injury. Prehospital Emergency …, 14(2), 240–244. http://doi.org/10.3109/10903120903564498

 Assessment and Initial Management of the Trauma Patient from Terrorist Events: CDC Downloadable Case Study

The New England Center for Rescue & Emergency Medicine Resources:

Squeeze Play: Medical Considerations for Crush Injury, Compartment Syndrome and Suspension Trauma

Do YOU have questions, comments or know of research or resources that we should include here? Let us know below.

About romduck

Rom Duckworth is a dedicated emergency responder and award-winning educator with more than twenty five years of experience working in career and volunteer fire departments, public and private emergency services and hospital based healthcare systems. Currently a career Fire Captain / Paramedic and EMS Coordinator Rom is a frequent speaker at national conferences and a regular contributor to research, magazines, and textbooks on topics of field operations, leadership, and education in emergency services. Contact Rom via www.romduck.com