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:


 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.

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

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.

Sahjian, M., & Frakes, M. (2007). Crush Injuries. Advanced Emergency Nursing Journal, 29(2), 145–150.

Sahjian, M., & Frakes, M. (2007). Crush injuries: pathophysiology and current treatment. The Nurse Practitioner, 32(9), 13–18.


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.


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.

Mortimer, R. B. (2011). Risks and management of prolonged suspension in an Alpine harness. Wilderness & Environmental Medicine, 22(1), 77–86.

Pasquier, M., Yersin, B., Vallotton, L., & Carron, P.-N. (2011). Clinical update: suspension trauma. Wilderness & Environmental Medicine, 22(2), 167–171.

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. (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.


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.

Burns, K., Cone, D. C., & Portereiko, J. V. (2010). Complex extrication and crush injury. Prehospital Emergency …, 14(2), 240–244.

 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, author, and educator with more than thirty years of experience working in career and volunteer fire departments, hospital healthcare systems, and private emergency medical services. Rom is a career fire captain and paramedic EMS Coordinator for the Ridgefield (CT) Fire Department and director of the New England Center for Rescue and Emergency Medicine. Rom holds a master’s degree in public administration, is a graduate of the National Fire Academy’s Executive Fire Officer program, and is the recipient of the NAEMT Presidential Award, American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award. Rom is the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. A member of the NAEMT Board of Directors, as well as other national and international advocacy and advisory boards, Rom continues to work for the advancement of emergency services professions. Contact Rom via