Üsküdar University NPİSTANBUL Hospital Internal Medicine Specialist Assist. Assoc. Dr. Ayhan Levent gave information about Crush syndrome, which is defined as the crushing of the body when trapped under debris in earthquakes, and made important recommendations.
Stating that Crush means 'crush' as a word, Internal Medicine Specialist Dr. Ayhan Levent, “Crush syndrome; It is defined as the condition that causes significant tissue damage and muscle necrosis as a result of crushing injuries, prolonged compression and immobility in disasters such as earthquakes, blows in work and traffic accidents, avalanches and being under the snow mass.
Dr. Ayhan Levent said that Crush syndrome occurs as a result of the muscle tissue being exposed to long-term pressure and continued his words as follows:
“In an earthquake, a large amount of weight is created on the body that is under the rubble. When the earthquake victim is removed, the areas under pressure are released and blood flow begins. Potassium, myoglobin, phosphate, creatine kinase, lactate dehydrogenase, AST, ALT and uric acid, which are normally found in muscle, pass from damaged muscle tissue into the bloodstream. These substances, whose levels rise in the blood, can cause toxic and fatal complications. These complications are; It includes internal and surgical complications such as acute renal failure, heart failure, hyperkalemia, hypovolemic shock, respiratory failure, infections, compartment syndrome, bleeding. Especially high potassium in the blood causes fatal arrhythmias. Because of these deadly rhythms, the person who is well under the rubble may be lost after being rescued.”
Stating that Crush syndrome is observed in 2-3 percent of the injuries in the earthquake, Dr. Ayhan Levent, “Crush syndrome is the second most common cause of death in disasters after direct trauma. Rescue death can be observed in the person with crush syndrome. It does not pose a problem when it is under the debris, since the metabolites that occur as a result of injury in the striated muscles due to the pressure on the earthquake victim do not pass into the bloodstream. However, when the earthquake victim is rescued from the wreckage, the pressure disappears, and then the metabolites enter the bloodstream and cause rapid death, which is called rescue death.
Emphasizing that the most important step in reducing death and disability from complications arising from Crush syndrome is early recovery and early treatment, Dr. Ayhan Levent said, “It is necessary to start the treatment while the earthquake victim is still under the rubble. Excessive crushing of the muscles can progress to a process that can result in death if fast and effective treatment is not applied. The most important step of the treatment is to start the serum treatment with isotonic sodium chloride (NaCl) at a rate of 1 lt/hour by opening the vascular access as soon as possible.
Dr. Ayhan Levent, “The symptoms of Crush syndrome, which develops as a result of mixing the contents of the squashed striated muscles into the blood circulation, include painful and swollen limbs, low blood pressure, weakness, heart rhythm disorder, respiratory failure, decreased urine volume and dark colored urination. The general health status of the person who was removed from the wreckage can be determined well at the first stage. There may be symptoms such as swelling in a single limb, weakness in the limb, or inability to move it. However, after a while, a decrease in blood pressure, respiratory failure and death may occur. In conclusion, Crush syndrome is an important syndrome that can be life threatening. With appropriate treatments, deaths due to Crush syndrome can be minimized.