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Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker

Published online by Cambridge University Press:  28 March 2016

Alvaro Mardones ,
Pablo Arellano ,
Carlos Rojas ,
Rodrigo Gutierrez ,
Nicolas Oliver  and
Vincenzo Borgna
Alvaro Mardones
Affiliation:
Santiago Fire Department, Urban Search & Rescue Task Force, Santiago, Chile Universidad del Desarrollo, Faculty of Medicine, Santiago, Chile Clínica Alemana, Emergency Department, Santiago, Chile
Pablo Arellano
Affiliation:
Colina Fire Department, Medical Department, Santiago, Chile
Carlos Rojas
Affiliation:
Hospital del Trabajador, Orthopaedics & Traumatology Unit, Santiago, Chile
Rodrigo Gutierrez
Affiliation:
Hospital del Trabajador, Orthopaedics & Traumatology Unit, Santiago, Chile
Nicolas Oliver
Affiliation:
Santiago Fire Department, Urban Search & Rescue Task Force, Santiago, Chile
Vincenzo Borgna*
Affiliation:
Santiago Fire Department, Urban Search & Rescue Task Force, Santiago, Chile Barros Luco-Trudeau Hospital, Urology Unit, Santiago, Chile
*
Correspondence: Vincenzo Borgna, MD, PhD Santo Domingo 978 Santiago, Chile 8320292 E-mail: vborgna@gmail.com
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Abstract

Introduction

Crush syndrome, of which little is known, occurs as a result of compression injury to the muscles. This syndrome is characterized by systemic manifestations such as acute kidney injury (AKI), hypovolemic shock, and hydroelectrolytic variations. This pathology presents high morbidity and mortality if not managed aggressively by prehospital care.

Clinical Case

A 40-year-old worker was rescued after being buried underground in a ditch for 19 hours. The patient was administered early resuscitation with isotonic solutions and monitored during the entire rescue operation. Despite having increased plasma levels of total creatine kinase (CK), the patient did not develop AKI or hydroelectrolytic variations.

Conclusion

Aggressive early management with isotonic solutions before hospital arrival is an effective option for nephron-protection and prevention of crush syndrome.

MardonesA, ArellanoP, RojasC, GutierrezR, OliverN, BorgnaV. Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker. Prehosp Disaster Med. 2016;31(3):340–342.

Keywords

acute kidney injurycrush syndromerhabdomyolysis
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 3 , June 2016 , pp. 340 - 342
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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