Crush injury with entrapment — DipIMC MCQ

Correct answer: E — Start warmed intravenous crystalloid before release and prepare for hyperkalaemia

Start warmed intravenous crystalloid before release and prepare for hyperkalaemia is the best answer because prolonged compression risks reperfusion injury, rhabdomyolysis and hyperkalaemia after release. Transport without treating the identified time-critical problem is less appropriate because movement alone may not reverse the immediate physiology; Delay intervention until arrival at hospital is less appropriate because delay is unsafe when a reversible pre-hospital threat is present. Give a large crystalloid bolus before controlling the injury and Perform a full secondary survey before treating the abnormality are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; ATACC Manual