Crush injuries is a form of blunt trauma. It typically occurs when a particular part or the body as a whole is exposed to a high degree of pressure, typically after being squeezed by two heavy objects. It usually caused swelling of the muscles and/ or neurological disturbances in the affected areas of the body. The most commonly affected areas of crush injuries are the lower extremities (74%), upper extremities (10%), and trunk (9%). Crush injuries is different from crush syndrome, a type of localized crush injury with systemic manifestations, which occurs as a result of traumatic muscle breakdown (rhabdomyolysis). It causes the discharge of possibly toxic muscle cell components and electrolytes into the circulatory system, which in turn can lead to multiple metabolic abnormalities in the body. Crush injuries are generally considered medical emergencies.
Causes of Crush Injuries
Compressive forces are the main cause of crush injuries. It can cause damage either through direct compression, (a direct and crush force) or by compressing tissues, thus restraining flow of blood to the cells in the affected area. A wide range of mechanisms can cause crush injuries, such as: Direct force
- Most common type
- An object or two applies direct force and destroys tissue
- E.g. heavy objects falling from greater heights
Entrapment or Weight-Based Compression
- Tissue compression is brought about by the position of the patient
- Usually manifests over hours – and at times days
- Compressions results to restriction of blood flow
- E.g. individuals who fall and cannot get up, victims trapped and pinned by bomb blasts and earthquakes
- Internal swelling results to compartment syndrome
- Tissue damage is caused by internal compression and restraining blood flow
Signs and Symptoms of Crush Injuries
When compressive forces damage tissues, it can lead to the following signs and symptoms:
- Bleeding and bruising
- Injury to the nerves
- Smashed fingers and/ or toes
- Infection secondary to the crush
- Compartment syndrome – the increased pressure in the arm or leg causes serious damage to the muscle, nerve, blood vessel and tissue (a complication of blunt trauma)
First Aid Management of Crush Injuries
Majority of crush injuries require the evaluation of emergency department and surgery to completely correct and treat the problem. First aid responders may do the following in case of crush injuries:
- If the individual is unconscious, check his/ her airway, breathing and circulation. If necessary, initiate CPR immediately.
- Apply direct pressure to control bleeding.
- Cover the affected area using a bandage or wet cloth. If possible, elevate the area above the heart level.
- For further advice, call the local emergency number.
To learn more about how to manage crush injuries caused by compression forces, enroll in First Aid Courses.