Of crush injury patients receiving hospital care, about 50% develop crush syndrome. These symptoms can be life-threatening, but treatment can prevent and manage symptoms.
Horton & Mendez Injury Attorneys discusses crush syndrome and what you need to know.
How do you define crush syndrome?
Crush syndrome is a medical complication from a traumatic compression injury. The crushing injury destroys the muscle, which, in turn, releases harmful proteins into the bloodstream. These proteins can cause systemic complications, including kidney failure.
Understanding Crush Syndrome: A Medical Overview
Medical professionals who were among the first to recognize crush syndrome were studying soldiers with serious wartime injuries. Physicians sought to explain why these soldiers died of kidney disease.
Japanese physician Seigo Minami first noted the correlation between crushing events and kidney failure in 1923.
In their studies, physicians noted that the person was often stabilized while the limb was under crushing pressure. It wasn’t until after the limb was released and reoxygenation occurred that the patient began to show symptoms and eventual death.
Is crush injury the same as crush syndrome?
No. Crush injury is the traumatic event itself, followed by localized injury. Crush syndrome occurs when the injury prompts a chain of events that cause harm to other places and systems in the body.
Causes of Crush Syndrome
Events that may result in crush injury and crush syndrome include:
- An object falling on a person
- A vehicle rolling over someone
- Structure collapse
- Being pinned under equipment
- Stampede, rush of crowds
- Explosions
- Electrical accidents
- Wartime injuries
Compartment syndrome can cause crush syndrome.
For crush syndrome to occur, injuries are typically severe. Crush syndrome is a secondary and potentially serious complication of injuries that are usually already serious.
Harm from Crush Syndrome
Crush syndrome most commonly damages the kidneys. The proteins released from injured muscles can cause the death of certain cells in the kidneys.
Signs and Symptoms of Crush Syndrome
Signs and symptoms of crush syndrome may include:
- Pain
- Pale skin color
- Feeling pins and needles or abnormal skin feeling
- Loss of movement, paralysis
- No pulse
- Elevated levels of urea, creatine, potassium, and other substances
- Hypocalcemia, low calcium
- Hyperkalemia, high potassium
- Abnormal heart rhythm
- Changes in urine color
- Respiratory distress
There are many signs and symptoms of crush syndrome. Some may be noted by observation, while medical tests may reveal other indicators.
Immediate Medical Response to Crush Syndrome
While medical treatment cannot reverse tissue death, there are things that can be done to attempt to inhibit progression. Ideally, treatment at the scene of the injury will be mindful of the possibility of crush syndrome and serious complications. It’s often not best to move the patient immediately.
Medical care may be needed in a confined or unusual space.
Access to veins, even before the limb is freed, can allow responders to intervene swiftly.
Tourniquet use may be appropriate. Saline infusion can help stabilize the patient, and a central venous line can help monitor and balance fluids. A catheter can be used to monitor kidney function and urine production. As the patient is freed, their airway and breathing should be monitored.
Several tests can be used to evaluate substance levels, such as potassium, uric acid, calcium, and creatine kinase, in the body. The patient should be evaluated as a whole, using cardiac function, x-rays, compartment pressures, and other trauma assessments. The patient may benefit from dialysis.
Long-Term Complications Associated with Crush Syndrome
Crush syndrome is a life-threatening injury. Elevated levels of potassium can cause cardiac arrest.
Infection is also a serious risk. Kidney failure may occur, making dialysis necessary.
In addition to the kidneys, other organ dysfunction may develop, including in the heart and lungs.
Long-term complications can include disseminated intravascular coagulation (DIC), or abnormal blood flow, and blood clotting. Other complications include respiratory symptoms, pain, and swelling.
Usually, a patient will have other injuries that require long-term healing.
Legal Rights of Workers Diagnosed with Crush Syndrome
If you have been diagnosed with crush syndrome, it may be part of your claim for workers’ compensation. An injury must arise out of the course and scope of employment. When a crushing injury leads to crush syndrome and associated problems like renal failure, they are part of the workplace injury.
However, getting compensation isn’t always easy. Insurance companies often deny claims, even when hard-working individuals are left to suffer. You may have assistance from an attorney for workers’ compensation to pursue your benefits. Horton Mendez Injury Attorneys represents clients in workers’ compensation cases.
Preventive Measures To Avoid Crush Injuries at Work
Preventative measures to avoid crush injuries at work should happen daily on the job, including making sure workers are adequately trained, using chocks to prevent vehicles and equipment from sliding, and maintaining overall situational awareness. In addition, there are things that should happen long term like following building codes and addressing a work site to minimize the chance of falling objects or collapse.
Adequate fluid intake can help reduce the likelihood of crush syndrome.
Definitions
Crush syndrome is a complex medical condition. Here are some related terms that you might hear.
Bywaters’ syndrome: Another name for crush syndrome from Eric Bywaters, who wrote about the condition in 1941.
Creatine kinase: An enzyme in the muscles and brain. The enzyme can leak when damaged.
Ischemia: Loss of blood flow.
Myoglobin: A protein in muscles that is released from damaged muscle tissue into the bloodstream.
Renal system: Primarily the kidneys but all the body parts for removing waste from the body as urine.
Reperfusion syndrome: A dangerous body reaction when a crushed limb is released.
Traumatic rhabdomyolysis: Another name for the release of dangerous chemicals from injured muscles.
Contact an Experienced Jacksonville Workers’ Compensation Lawyer
If you have developed crush syndrome because of a workplace injury, please contact us. An experienced Jacksonville workers’ compensation lawyer from Horton & Mendez Injury Attorneys can discuss your case and how we can help. Call or message us now.
