Crush Injury with Dr. Joe Holley Clinical Episode

Dr. Joe Holley joins us for a clinical episode on Crush Syndrome and injury. The issue represents a broad spectrum of situations affecting the body. The disease process can be from becoming trapped in a collapsed structure or something as simple as passing out or becoming immobilized to lay on a hard surface for a significant period of time.

There are many ways to die from crush syndrome. First the risk is from the crushing injury itself. During a crush event, the muscle tissue becomes ischemic and leaks cellular contents into the surrounding tissues. Most often, the increased levels of potassium present from inside the crushed cells will recirculate via restored blood flow back to the heart and causes hyperkalemic arrhythmia.

The second byproduct of crush injury causes increase anaerobic metabolic processes. The acidosis that results can also be lethal if not recognized and treated rapidly. Thirdly, the crushed cellular debris circulates back through the vascular system upon restoration of circulation. This can cause a rapid inflammatory response across the body, including systems affecting clotting all over the body until clotting factors are used up and there’s no clotting response remaining.

Myoglobin, a large muscular protein, also is released into the blood and becomes trapped in the kidneys where it plugs up the renal filtration system. This causes end-stage renal failure within weeks of the event’s initial survival.

On the call were disaster management expert, Becky DePodwin, meteorologist Dan DePodwin, and co-hosts Sam Bradley and Jamie Davis.