Emergency War Surgery NATO Handbook: Part III: General Considerations of Wound Management: Chapter XVII: Crush Injury

General

United States Department of Defense

The "Crush Syndrome," or traumatic rhabdomyolysis, is a syndrome resulting from skeletal muscle injury, and the resultant release of muscle cell contents into the general circulation. This syndrome was first described in World War II air raid victims who had been trapped under fallen masonry. During peacetime, the syndrome may be seen in association with natural disasters such as earthquakes and mine cave-ins, or occasionally with vehicular disaster. Present-day terrorist activities utilizing high explosives and military operations in urbanized terrain represent current causes of the syndrome. Any individual who has been crushed beneath debris or run over, or whose limbs have been compressed for any reason for an hour or more, is at risk of developing the crush syndrome.

The collapse of a building due to an explosion causes immediate death among the majority of the victims due to the blast effect, the direct effects of the falling debris, the fire, or compression by the rubble. Immediate death is mainly caused by severe damage to vital organs. The survivors whose extremities are pinned under heavy rubble, thereby trapping them, are the ones at risk of developing the syndrome.

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Operational Medicine 2001

Health Care in Military Settings

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