line of duty shootingsWe dig into crush syndrome and a tie to the opioid epidemic for emergency responders in this episode of the Disaster Podcast with a clinical topic from Dr. Joe Holley. It’s a total body system-wide process that results from compression injury to muscle tissue releases toxins into the body.

EMS and disaster responders see crush syndrome more frequently than we might think we do. While we think about collapsed structures and heavyweights compressing the body for an extended period of time.

For example: consider an elderly person who falls and breaks a hip then is unable to call for help and remains in a static position for an extended period of time. This prolonged positional crush syndrome is often unrecognized in the field. Similar cases are seen in opioid and other unconscious overdose patients.

The primary cause of injury from crush syndrome is related to rhabdomyolysis and kidney function problems. It starts when muscle tissue becomes ischemic because of position, compression, or crushing injury. As the cells die, they rupture and release intracellular contents including large protein molecules like myoglobin along with potassium ions.

The myoglobin becomes lodged in the filtration system of the kidneys and causes renal failure while the flood of potassium has significant cardiac side effects. Overall acidosis from anaerobic metabolism during the crush incident causes a failure or reduction in the patient’s compensatory mechanisms.

Also on the show this week are Sam Bradley and co-host Jamie Davis, plus the Disaster Podcast disaster weather expert, Kyle Nelson.

Disaster Never Sleeps, Neither Do We

We will be bringing you more special updates from our Disaster Podcast team members as we get them in from around the world.

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Paragon Brings “The Experience”

Paragon Medical Education Group specializes in bringing what they call “The Experience” to jurisdictions around the country. They bring together police, fire, EMS, and hospital teams to train together and learn what to expect from each diverse group in the response team so that each knows what to expect from the other and how to back the other groups up. Visit Paragon’s site at for more information on how this can be brought into your system.


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