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Crush injury — DIPIMC MCQ

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HardPre-Hospital TraumaCrush injuryDIPIMCDipIMC

A builder has been trapped under a collapsed wall for three hours with both legs pinned. He is currently haemodynamically stable. Extrication is expected in around ten minutes.

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: AEstablish intravenous access and give fluids before the crushing force is released.

Prolonged crush injury risks crush syndrome with hyperkalaemia, myoglobinuria and reperfusion collapse, so intravenous fluids are started before the compressing force is released. Sudden release without preparation can precipitate cardiac arrest from a surge of potassium and acid. Potassium administration would be actively harmful in this setting.

Reference: JRCALC Clinical Guidelines