Crush injury, crush syndrome

Abstract

Crush injury (CI) is defined as a direct and local injury to the limbs that is caused by continuous prolonged pressure, basically causing damage to the muscle cells. Crush syndrome (CS), or reperfusion syndrome, is the systemic manifestation of CI (systemic pathopysiological and biochemical clinical picture, e.g. renal failure). As the definition indicates, a victim must be either buried or pinned down for a substantial period of time for CI to develop. The minimal time for this process, as delineated by Bywaters, is 2 hours. 1,2 While one report mentions less than 1 hour,3 the usual time is much longer. This limits the cases of developing CI to patients whose extrication is delayed, and the obvious scenarios are mine accidents, tunnel accidents, earthquakes, and bombed buildings.3-6 It is also highly relevant to terrorist attacks. In each of these scenarios, extrication may take a long time because of technical problems. © 2009 Springer New York.