title: Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker.
abstract: Introduction Crush syndrome, of which little is known, occurs as a result of compression injury to the muscles. This syndrome is characterized by systemic manifestations such as acute kidney injury (AKI), hypovolemic shock, and hydroelectrolytic variations. This pathology presents high morbidity and mortality if not managed aggressively by prehospital care. Clinical Case A 40-year-old worker was rescued after being buried underground in a ditch for 19 hours. The patient was administered early resuscitation with isotonic solutions and monitored during the entire rescue operation. Despite having increased plasma levels of total creatine kinase (CK), the patient did not develop AKI or hydroelectrolytic variations.
  
  
  CONCLUSIONS
  Aggressive early management with isotonic solutions before hospital arrival is an effective option for nephron-protection and prevention of crush syndrome. Mardones A , Arellano P , Rojas C , Gutierrez R , Oliver N , Borgna V . Prevention of crush syndrome through aggressive early resuscitation: clinical case in a buried worker. Prehosp Disaster Med. 2016;31(3):340-342.
authors.affiliation: 1Santiago Fire Department,Urban Search & Rescue Task Force,Santiago,Chile.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Mardones
authors.affiliation: 4Colina Fire Department,Medical Department,Santiago,Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Arellano
authors.affiliation: 5Hospital del Trabajador,Orthopaedics & Traumatology Unit,Santiago,Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rojas
authors.affiliation: 5Hospital del Trabajador,Orthopaedics & Traumatology Unit,Santiago,Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Gutierrez
authors.affiliation: 1Santiago Fire Department,Urban Search & Rescue Task Force,Santiago,Chile.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Oliver
authors.affiliation: 1Santiago Fire Department,Urban Search & Rescue Task Force,Santiago,Chile.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Borgna
mesh_terms: D000328:Adult; D003444:Crush Syndrome / Q000503:physiopathology / Q000517:prevention & control*; D004190:Disasters; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D012151:Resuscitation / Q000379:methods*; D016896:Treatment Outcome
keywords: ABC airway; AKI acute kidney injury; ATLS Advanced Trauma Life Support; CK creatine kinase; acute kidney injury; breathing; circulation; crush syndrome; rhabdomyolysis