Crush syndrome in earthquakes - stay and play or load and go?

Scientific paper - Original scientific paper

• Title (croatian): Sindrom nagnječenja u potresima – ostati i zbrinjavati ili odvesti u bolnicu?
• Author: Iskra Alexandra Nola
• Author: Matija Dvorski
• Author: Mirza Žižak
• Author: Tomislav Kuliš
• Author's institution: University of Zagreb; School of Medicine; (Department of Physiology and Immunology)
• Author's institution: University of Zagreb; School of Medicine; (Department of Urology)
• Author's institution: University of Zagreb; School of Medicine; (Department of Environmental and Occupational Health)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Occupational and Sports Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Human Physiology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Urology

Abstract (english)

Earthquakes are unpredictable natural disasters accompanied by material damage and many victims. In the case of a person remaining trapped under the collapsed material, the development of crush syndrome can occur. Crush syndrome is the result of traumatic rhabdomyolysis and is present in 2%-15% of all injured persons in an earthquake. It is not easy to recognize, and proper treatment is challenging. Persons who have a clear crush injury and/or have been immobilized for more than four hours should be considered potential victims of crush syndrome. Therefore, knowledge about crush
syndrome must be comprehensive and accessible to all parties involved. In this paper, the management of crush syndrome victims, which includes the principles of triage, and medical and logistic principles as well, is presented. Triage principles are presented at the level of triage priorities, places, and diagnoses. Medical principles, crucial for crush syndrome, are presented regarding the duration of compression and time before or after extraction of the patient. Logistic principles provide an overview of the priorities and modes of transport in relation to distance of health institutions, and the importance of management and education associated with crush syndrome. Each country with recognized disasters (natural or manmade) in which crush-related victims are expected, will benefit if the knowledge about triage, medical and logistic principles for crush syndrome is incorporated in their educational programs and regularly updated.

Abstract (croatian)

Potresi su nepredvidive prirodne katastrofe praćene materijalnom štetom i velikim brojem žrtava. Kod prignječenih osoba, pod teretom ruševnog materijala može doći do razvoja sindroma nagnječenja. Sindrom nagnječenja rezultat je traumatske rabdomiolize, a prisutan je u 2%-15% svih ozlijeđenih osoba u potresu. Nije ga lako prepoznati, a pravilno liječenje je izazovno. Osobe koje imaju jasnu ozljedu nagnječenja i/ili su imobilizirane više od četiri sata trebale bi se smatrati potencijalnim žrtvama sindroma nagnječenja. To je razlog zašto znanje o sindromu nagnječenja mora biti sveobuhvatno i dostupno svim uključenim stranama. U ovom radu prikazano je upravljanje žrtvama sa sindromom nagnječenja koje uključuje načela trijaže te medicinska i logistička načela. Načela trijaže prikazana su na razini trijažnih prioriteta, mjesta i dijagnoza. Medicinska načela ključna za sindrom nagnječenja prikazana su s obzirom na duljinu trajanja prignječenja i vrijeme prije odnosno nakon izvlačenja bolesnika. Logistička načela daju prikaz prioriteta i načina transporta u odnosu na udaljenost zdravstvenih institucija te značenje upravljanja i izobrazbe povezane sa sindromom nagnječenja. Svaka zemlja izložena prirodnim katastrofama poput potresa, u kojima može doći do sindroma nagnječenja, imat će koristi ako se znanje o trijaži, medicinskim i logističkim načelima značajnima za sindrom prignječenja ugradi u njihove obrazovne programe i redovito obnavlja.

• Keywords (english): Crush syndrome; Earthquakes; Emergencies; Risk management; Triage
• Keywords (croatian): Krizne situacije; Potresi; Sindrom nagnječenja; Trijaža; Upravljanje rizicima
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Acta clinica Croatica
• Numbering: vol. Suppl. 2, no. 62, pp. 158-165
• p-ISSN: 0353-9466
• e-ISSN: 1333-9451
• DOI: https://doi.org/10.20471/acc.2023.62.s2.24
• URN:NBN: urn:nbn:hr:105:006687
• Publication: 2023
• Document URL: https://actaclinica.eu/wordpress/wp-content/uploads/2023/10/24_Nola.pdf
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-11-06 13:04:05