Crush Syndrome Pre-Extrication — FRCA Final MCQ

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HardTrauma & Emergency AnaesthesiaCrush Syndrome Pre-ExtricationFRCA Final

Trapped 6 hours, K+ 6.8, peaked T waves, widened QRS. What must be given BEFORE extrication?

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Correct answer: E — Calcium gluconate 30 mL + insulin-dextrose + NaHCO3

Crush syndrome: before extrication give calcium gluconate (cardiac membrane stabilisation), insulin-dextrose (drives K+ intracellularly), NaHCO3 (alkalinisation), aggressive IV fluids. On release, massive K+/myoglobin/phosphate bolus risks fatal hyperkalaemic arrest.

Reference: ATLS – 2018 – Crush injury; BBA/BAPRAS – 2023