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.
Crush Injury (and more)
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
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.
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)
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
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:
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