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Crush injury with prolonged entrapment — DipIMC MCQ

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HardTraumaCrush injury with prolonged entrapmentDipIMC

A 52-year-old demolition worker has both legs trapped under concrete for 90 minutes. He is conscious, thirsty, pulse 118/min, systolic blood pressure 102 mmHg, and extrication is imminent; there is no external bleeding. What is the most appropriate management?

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Correct answer: E — Establish IV access and begin controlled fluid resuscitation before release

Prolonged entrapment risks crush syndrome, hyperkalaemia and reperfusion shock; IV access and resuscitation should begin before release where feasible. Tourniquets are not routine for crush syndrome without catastrophic haemorrhage. Waiting for laboratory potassium is impractical and unsafe in the pre-hospital phase.

Reference: JRCALC Guidelines; ATACC