What Is A Crush Injury
A crush injury results from physical trauma induced by prolonged compression of the torso, limb(s), or other parts of the body. The resulting damage to the soft tissues, muscles, and nerves can be due to the direct effect of the trauma induced by that compression.
What Is The Difference Between Crush Injury Syndrome And Compartment Syndrome
Crush injury (CI) and compartment syndrome (CS) are different processes with similar pathophysiology, and as a result, they are frequently discussed and incorrectly used interchangeably.
Although trauma is the most likely cause of CS/CI, both can occur in non-traumatic situations. A stroke patient or diabetic found unconscious after lying motionless on a limb for several hours could have acquired an unidentified compartment syndrome injury. The injury might go unnoticed if the first person on the scene moved the patient to assess DRSABCD protocols and failed to mention it to the attending medical experts.
Crush Injury:
A crush injury stems from prolonged continuous pressure on a large muscle group like the torso, legs, or arms, resulting in disintegrating of the muscles.
Let’s say you are working under the car, the jack gives way, and you are pinned under the vehicle from the chest down. That is a crush injury.
Compartment syndrome:
Compartment syndrome is defined as any condition in which a nerve or tendon has been constricted within a space.
Let’s say you are taken hostage and forced to lie on one of your arms for hours without movement. The weight of your body compressing the limb causes the nerves, tissues, blood vessels, and tendons to be compressed, causing compartment syndrome.
The symptoms of compartment syndrome are:
- Extreme pain
- You feel pins and needles when weight has been on an area for too long and goes numb.
- Paralysis of the limb
- No pulse in the affected limb
- Swollen and shiny skin
What Damage Can Crush Injuries Cause
The likelihood of developing acute crush syndrome is directly related to the amount of time spent under compression. The casualty should be released as quickly as possible, irrespective of how long they have been trapped, where it is physically possible to free them from or remove the crushing force. Crush syndrome can cause disruption to the body’s chemistry and, when combined with the onset of shock, cause heart, breathing & kidney failure.
Damage related to crush injuries can include bleeding and bruising and lead to compartment syndrome. The increased pressure in an arm or leg causes serious muscle, nerve, blood vessel, and tissue damage. At the worst end of the spectrum, permanent nerve and blood supply issues might lead to paralysis and necessitate the limb be amputated. The best-case scenario is a full recovery with no lasting effects on the area the body cannot repair and regenerate.
What Medical Tests Indicate A Crush Injury Has Occurred
Serum creatinine kinase (CKMM) levels greater than 1000 IU/l with associated clinical features are generally taken as a clinical indicator that crush syndrome is present and that a crush injury has occurred where there might be doubt. The normal range of CKMM in a non-injured person is 25-175 U/l. In crush injuries, the level usually rises 2 to 12 hrs after the crush injury has occurred, peaks in 1 to 3 days, and declines after 3 to 5 days.
First Aid For Crush Injuries
Thankfully, the chances of receiving a crush injury in the average daily life are slim for the normal person. People who work with heavy machinery or weights of any kind as a career necessity have an increased risk of receiving a crush injury on the job site. High-risk occupations are those who work at height and might fall to impact the ground, such as riggers and scaffold construction workers.
Accidents are also the wild card entry here. You might be at the back of your car putting the shopping into your boot when a car backs into you, crushing your lower limbs between the two vehicles. Your toddler might see the furniture as a challenge and decide to give climbing the tallboy, entertainment unit or bookshelf a go, and it topples over and pins them under its weight.
Thankfully there is a way to offer First Aid treatment, and if you are reading this, it is time you took a First Aid course with an accredited RTO who specialises in all things First Aid.
What To Do For Crush Injury Patient
Don’t panic! Call 000 as you remove the weight from the person where it is physically possible to do so as quickly as possible to prevent compartment syndrome from developing.
If they are unconscious:
- Begin DRSABCD protocols and assess for further danger to yourself or the person.
- Assess breathing and level of unconsciousness.
- Provide CPR if they are not breathing and are non-responsive without a heartbeat.
- If they recover, monitor closely and keep warm and reassured while waiting for emergency services to arrive and take over.
- Address and control any bleeding and wounds.
- Keep them on their back and treat them for suspected spinal injuries as a precaution.
If breathing:
- Assess for any bleeding or wounds that require First Aid.
- Control the bleeding by applying pressure to the wound area.
- Keep the person warm and ask questions about their pain level and any issues they have, like headache, can’t move limbs, can’t feel anything etc.
- Watch and treat for shock while you treat for potential spinal or head injuries.
- Reassure and monitor the person until help arrives.
- Do not leave the person unless it is required to call emergency services as crush injuries of the torso can lead to breathing and heart failure requiring CPR to be started.
People with crush injuries might not complain of pain as nothing is ‘broken’. They still need assessment by a doctor for tests to rule out or monitor the body’s chemical balance to prevent heart attack or onset of serious medical difficulties that develop hours after the initial injury has been sustained.
Take A First Aid Course
Now is the perfect time to take on new activities and broaden your knowledge and skillset by taking a First Aid course. First Aid is something every person on the planet should learn from a young age. With Basic First Aid courses from under $100, becoming a potential lifesaver has never been so affordable!
One weekend is all it takes to transform your life and give you the skills to save others. Don’t live with the regret and guilt of not being able to save a life because you didn’t know what to do. Visit our First Aid Course Experts Blog page and read up on a wide range of First Aid topics for motivation and inspiration prior to taking your First Aid course with FACE.
Book your place on the next available FACE course in your area.
