Crush injury is an injury that occurs when the body is crushed or under strong pressure from a heavy object. This injury is an emergency condition which if not treated immediately can result in paralysis, amputation, and even death.
Crush injury can cause the blood supply to the squeezed organ to be obstructed resulting in organ damage. Not only that, squeezed body muscles can be destroyed and release substances that damage the kidneys.
Causes of Crush Injury
Crush injury can be caused by several factors, namely:
- Motor vehicle accidents or other types of transportation, such as trains or planes
- Occupational accidents, especially workers in the mining, construction and agricultural industries, without personal protective equipment while working
- Dropping a heavy object on your foot or catching your finger in a door or window
- Natural disasters, such as earthquakes, tsunamis, hurricanes, or landslides
- Bomb explosion
Symptoms of Crush Injury
Injuries that cause damage to muscles, bones and certain organs of the body, can cause symptoms in the form of:
- Terrible pain
- Numbness in the squeezed part of the body
- An open wound that causes damage to the skin surface and heavy bleeding
- Open fracture
- Decreased body temperature (hypothermia)
- Pale skin, and blue lips or fingers
- Urine is red or brown
- Hard to breathe
- The pulse is weak
- Blood pressure drops
- Loss of consciousness
When to see a doctor
Immediately call an ambulance service if anyone around you has had a crush injury after an accident. If possible, immediately take him to the emergency room doctor . Handling needs to be done immediately to prevent organ damage and death, as well as other fatal complications.
There are several first aid efforts that can be done if you find a crush injury victim before receiving treatment at the hospital, namely:
- Check the victim's level of consciousness, whether the victim can still respond to questions or open his eyes.
- Check the victim's vital signs, such as heart rate and respiratory condition.
- Make sure the victim's airway is open and the victim can breathe normally by looking at the chest or stomach moving up and down.
- Make every effort to make the victim feel safe and not panic.
- If the victim is bleeding, try to stop the bleeding by finding the source of the wound, then applying firm pressure to the area.
- Check the condition of the skin around the injured area for changes in the color of the skin that are pale or blue due to bleeding in the body.
- If bleeding continues and is life threatening, use a bandage and bandage to cover the source of bleeding.
- If any part of the victim's body is cut, stop the bleeding and clean the area around that part of the body. Store the severed body parts in plastic, seal tightly, and place in a container of ice.
- If the victim is suspected of having a dislocated or fractured bone, keep the victim from moving too much, or make a splint to keep the broken part of the body from moving.
- Make sure the victim is in a comfortable position and provide blankets to keep the victim warm.
- Monitor respiratory conditions and level of consciousness, and accompany the victim until medical help arrives.
Crush Injury Diagnosis
Before making a diagnosis, the doctor will stabilize the patient's condition first with the following actions:
- Ensuring the airway remains safe and unobstructed
- Provide supplemental oxygen through a breathing apparatus
- Stop bleeding
- Provide intravenous fluids and blood transfusions
- Inserting a urinary catheter
After the patient is stable, the doctor will ask the person who took the patient to the emergency room about the process of the injury. Next, the doctor will carry out a thorough physical examination. If needed, the doctor will also carry out supporting examinations, such as:
- Blood tests, to check hemoglobin levels, signs of electrolyte disturbances, infections, and other conditions
- Scanning with X-rays, to see the condition of the broken bones
The doctor can also perform a CT scan or MRI to examine the condition of the injury to the internal tissues and organs, as well as determine the severity of the injury. However, this method is very rarely used in the initial diagnosis of patients, because the procedure takes a long time.
Crush Injury Treatment
Further treatment given by the doctor depends on the type of injury suffered by the victim. After knowing the type and severity of the injury, the doctor will determine the actions that need to be given, including:
O medicine _
As a first step in treating the injury, the doctor will give you several types of drugs. Most of these drugs will be given by injection or infusion, including:
- Strong pain relievers, such as ketamine , to relieve pain from an injury
- Tranquilizers or sedatives, such as benzodiazepines, to relieve muscle tension and anxiety
- Antibiotics, to prevent bacterial infections, especially in open wounds
Surgery is performed to control bleeding and treat injuries to internal organs. The type of surgery to be performed depends on the location of the injury and bleeding, namely:
Laparotomy is a surgical procedure performed by making an incision in the abdominal wall. That way, the doctor can check the condition of the organs in the stomach and detect bleeding.
The goal of a thoracotomy is to stop the bleeding and relieve pressure on the heart and lungs. This procedure is performed by making an incision along the rib cage.
Fasciotomy is performed by cutting the lining covering the organ (fascia), in order to relieve tension or pressure in the muscles and nerves which can result in impaired blood circulation to the area. The goal is to save the body's organs from damage caused by compartment syndrome.
Amputation is the cutting of certain body parts to prevent further damage or complications that can be life-threatening. Amputation is performed if the crush injury is at risk of becoming gangrene .
Crush Injury Complications
There are several complications that may occur if the crush injury is not treated immediately, namely:
Crush syndrome or Bywaters syndrome is a medical condition characterized by shock and kidney failure resulting from serious injury to the skeletal muscles ( rhabdomyolysis ).
The intense pressure from a crush injury can cause muscle cells to break down and release myoglobin. Myoglobin released in large quantities is toxic to the kidneys.
Compartment syndrome can occur when the muscle tissue and its surroundings do not get blood supply for a long time due to increased pressure in the muscles. This condition can cause nerve damage and muscle death.
Compartment syndrome is characterized by severe pain accompanied by tingling, which can even cause paralysis. The hallmark of compartment syndrome that can be seen is swelling of the skin.
Apart from the conditions above, crush injury can also cause other complications, such as:
- Amputation of arms or legs
- Damage to the shape of the limbs
- Permanent paralysis
Crush Injury Prevention
Crush injuries that occur as a result of natural disasters or war cannot be prevented. However, there are several efforts that can be made to avoid factors that can cause crush injury , namely:
- Follow procedures and use proper personal protective equipment (PPE) when working, especially when using large and heavy tools or machines.
- Wear a seat belt and helmet when driving, and make sure to always be careful and obey traffic signs.
- Avoid doing activities around the building construction area.