ACTION/TREATMENT:
- 1. ABCs/monitor cardiac rhythm/spinal immobilization/control hemorrhage.
2. Protect the airway/oxygen via facemask for dust inhalation protection.
3. Wipe out mouth with damp cloth.
4. Provide a barrier protection mask, if O2 is not safe to administer, to act as a dust filter.
5. Advanced airway prn.
6. IV access in unaffected limb:
7. Normal saline 20 mL/kg up to 2 liters for fluid resuscitation, prior to release of compression force.
8. Psychological support.
9. Consider Albuterol for possible hyperkalemia (peaked T-waves or wide QRS > 0.12 seconds), wheezing or bronchospasm:
10. 3 ml (2.5 mg) of a 0.083% solution nebulized. May repeat.
11. Sodium bicarbonate (NaHCO3) 1 mEq/kg IVP. (FOR CRUSH SYNDROME)
12. Morphine sulfate for pain: 2-20 mg IVP titrated to pain, or 10 mg SQ one time.
13. Isolated extremity trauma. Not recommended for multi-system injury or systolic BP
14. Release compression and extricate patient.
15. Non-compressive splints/dressings prn.
16. Keep affected limb at level of the heart.
Pediatric:
- 1. IV access in unaffected limb:
2. Normal saline 20 ml/kg for fluid resuscitation, prior to release of compression force.
3. Consider Albuterol for possible hyperkalemia, wheezing or bronchospasm:
4. 3 ml (2.5 mg) of a 0.083% solution nebulized. May repeat.
5. Sodium bicarbonate (NaHCO3) 1 mEq/kg IVP. (FOR CRUSH SYNDROME)
6. Morphine sulfate for pain: 0.1 mg/kg slow IVP or SQ one time.
Note:
- - Confined space and a MVI situation may compromise treatment. Ideally, treatment should be started prior to release of compression.
- Hydrate prior to release of compression to combat hypovolemia and to dilute cellular toxins.
- Contact hospital for determination; consider trauma receiving center.
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