What is Crush Syndrome?

Many have never heard of Crush Syndrome and do not understand how life threatening it may be. Crush Syndrome is most often seen after a major disaster, natural or otherwise. Crush Syndrome will often occur when a person becomes pinned between two or more objects that cause a crushing of the muscular and skeletal systems. Crush syndrome is most often characterized by shock and renal failure.

Crush syndrome first discovered by physician Eric Bywaters in 1941 after a blitz in London. He became aware that patients released from crushing pressure all exhibited the same symptoms; he believed the releasing of the patient from being pinned caused a release of muscle breakdown products. These products would be myoglobin, phosphorus, and potassium and once released caused the kidneys to malfunction, the toxins released with the myoglobin are believed to be the most prominent cause.

Crush Syndrome is often referred to as a silent killer as it is unfortunately very common for patients not to exhibit any outward signs of the syndrome until it is too late to help them. The symptoms that can be associated with the syndrome are kidney failure, blood vessel restriction and possible heart attack and the patient may also be clammy and pale and a rapid but weak pulse rate.

In previous years many that suffered from Crush Syndrome had little to no chance for survival due to their lack of outward signs and that little was known about the syndrome. In recent years there has been a more standardized treatment initiated with the episodes of earthquakes that have occurred over the last 10 years. It was discovered that once the person is freed from the rubble it is important to start an IV of normal saline solution not a ringer’s lactate solution because it contains potassium. It is also recommended that sodium bicarbonate solution be given with ever bag of saline solution to increase urine output and so that the myoglobin will be more soluble.

There are several other treatments that may have to be used for treatment of Crush Syndrome such as surgery to repair nerves that were damaged and renal replacement therapy may be advised as kidney function is often diminished soon after the injury occurs. Hemodialysis is often recommended and involves the patient’s blood being run through a filter that will remove the build-up of waste products, and then the blood will be returned to the patient.

Fortunately much more is known about Crush Syndrome today and people who have suffered this injury have a greater chance of being able to survive this traumatic injury. It is also possible that hemodialysis may have to be a part of the person’s life for a while after the injury due to the need to filter out the toxins that were released in the body, but this is usually only necessary for days to weeks after the injury occurred. Many more people have survived being crushed in the last 10 years since the greater understanding of what happens to the body is now known.

“Blast Injuries: Crush Injury and Crush Syndrome.” CDC

“Acute Kidney Failure” Medline Plus

Jim Holliman Ph.D. “Crush Injury and Crush Syndrome,” Yale New Haven Health