Crush syndrome (crush syndrome): first aid, treatment and symptoms
How to give first aid in crush syndrome: causes and symptoms
Compartment syndrome – a serious pathological condition in which the crushing of the tissues of the extremities.
SDS still bears the name of crush-syndrome, crush syndrome, syndrome crushing.
For the first time the disease was studied and explained the famous scientist N. And.Pies. It is a severe and dangerous pathology, which is characterized by a peculiar clinical picture and, unfortunately, high frequent deaths.
This condition causes prolonged compression of soft tissues. Typically, the crush syndrome is observed in case of earthquakes, blockages, accidents, military combat, destruction of buildings, etc.
How is crush syndrome?
Experts say that compartment syndrome begins to develop after two hours of pressure on the soft tissue.
At the beginning of the compression changes occur in the tissues, began to circulate blood, as the compressed blood vessels and nerve endings.
If the compression takes a long time, the blood circulation stops completely. Reduced supply of oxygen, which causes hypoxia. It affects many organs.
4-6 hours after being crushed are formed and destruction processes, leading to blockage of blood vessels of the kidneys and other organs. Also, when the crush syndrome begins from severe intoxication, toxic substances to the affected tissues.
As soon as the compression ceases, all of these substances enter the blood and cause severe poisoning. Prolonged compression of limbs ensues a state of shock and full cardiac arrest.
What triggers the development of SDS?
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The formation of SDS is accompanied by several key factors:
- Strong pain syndrome. Prolonged pain is reason for formation of traumatic shock.
- A great loss of blood and plasma. This condition leads to blood clots and thrombosis.
- Traumatic intoxication. This situation develops due to absorption of foods that get into the blood in the decay of muscle tissue. It often causes arrhythmia, develops acute renal failure, in extreme cases, cardiac arrest.
The dependence of the symptoms from stage pathology
Clinical symptoms there are three main stages of development of the pathology:
- Early stage is marked by a buildup of tissue edema and vascular insufficiency, last up to 3 days. The victim marked weakness, nausea, severe pain, limited movement, swelling of the extremities. In addition, increased body temperature, there is rapid heartbeat, racing blood pressure. The skin becomes pale, covered with cold sweat. Sometimes diagnose pulmonary edema, observed in a state of shock.
- Toxic stage refers to the period of acute renal failure, continuing from 3 to 12 day. There is a strong swelling of the limbs, the skin takes on a purple-blue color, blistering, suppuration of wounds you receive. When seeing the fabric dense and stiff joints when you try to call their movement there is a severe pain, lost sensitivity. In the period of kidney failure drastically reduced the amount of urine, it becomes dark in color, has high protein content. Increases toxicity, which can cause hepatitis and endotoksicski shock. In this state urgently need medical assistance.
- Stage of late complications of compartment syndrome comes about a month after the trauma. The patient feels better, pain and swelling are reduced, the body temperature comes back to normal. But also, the symptoms of this period is the atrophy of muscle and contractures occur because non-viable tissue is replaced by connective and it often leads to immobility, in rare cases, possible sepsis.
The first emergency treatment of the compartment syndrome, is that initially it is necessary to free the body, clear the mouth and nose from foreign bodies and if necessary, apply artificial respiration.
Then enter the intramuscular injection of morphine, and if possible, to make novocaine blockade of the limb, to the wound, apply antiseptic.
The limb tight bandage, immobilizing and apply ice packs or cold water.
The tourniquet is only necessary in those cases when it is necessary to stop severe bleeding and there’s damage to the main artery.
Then transporterowych the patient to the nearest medical center, where follow-up treatment. Also during the evacuation, continue to impose painkillers and sedatives to ease the patient’s condition.
It must be remembered that first aid depends largely on the life of the victim.
Therapy in the hospital
Treatment of crush syndrome is complex, involves shock and resuscitation therapy.
First, the treatment reduces the development of toxins, normalize the functioning of the cardiovascular system, improve blood circulation, restore renal function.
In the most severe cases, carried out anti-shock therapy, a role attribute to the anesthesia. Second, intensive treatment of wounds and abrasions with antiseptic and dehydrating means, parallel to the applied antibiotic therapy.
Surgery is required in cases when severely impaired blood circulation, it is necessary to remove the bony fragments and foreign bodies in the tissues, etc.
The operation helps to establish blood flow, to remove the compression of the tissues, as well as on areas where there is exposed bone, apply a tissue. Some cases require amputation of limbs, plastic fabrics, etc.
During convalescence the patient must undergo rehabilitation and recovery period, which involves special exercises, physiotherapy, Spa treatment. In addition, victims need subsequent long-term observation.
Treatment of compartment syndrome depends on the extent of damage and General condition of the patient.
Complications and prognosis: the trouble is inevitable
Late treatment may develop serious complications.
Is the atrophy and contracture of the muscles, decreased renal function, pulmonary insufficiency. Sometimes the above condition can lead to total disability.
The prognosis depends on the duration of the traumatic process:
- If the crush didn’t last more than 4 hours, then 70-80% of patients have chances of survival and partial recovery.
- When this state lasted for about 4 to 6 hours, you receive a shock, but able to survive half of patients.
- While squeezing one or both of the limbs more than 8 hours, the prognosis is unfortunately unfavourable in almost all the victims, is awaiting death in a few days.
In each case the peculiarities of crush syndrome individual. This is largely dependent on the volume of the lesion, characteristics of the patient, proper treatment.
But still, remember that you need to be careful and avoid situations where you can cause irreparable harm to their health.