Analysis of Pre-hospital First Aid for 51 Cases of Crush Injury_West China Medical Journal

Authors：

 ChenHuaixiang ,  TianHaiping , LiuXuejun

Chongqing Three Gorges Emergency Medical Center, Wanzhou, Chongqing 404100, P. R. China;

Corresponding?author：

TianHaiping, Email: 327005649@qq.com

Keywords：

Crush injury; Crush syndrome; Pre-hospital first aid; Knowledge; Prognosis

DOI：

10.7507/1002-0179.20160013

Video：

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Objective To understand the pre-hospital emergency medical staff's knowledge on crush injury and crush syndrome, and the influence of active and effective pre-hospital measures on the prognosis of patients with crush injury. Methods We retrospectively analyzed the clinical data of 51 patients with crush injury treated from September 2004 to August 2014, and recorded the number of cases in which pre-hospital emergency medical staff recognized and/or took effective measures to control crush syndrome. Treatment group included those patients who accepted effective prevention and control measures, and the rest of the patients were included in the control group. We compared the two groups of patients in terms of the incidence of serious complications such as crush syndrome and amputation. Results Twenty-five cases (49.0%) of crush injury were recognized before the patients were admitted into the hospital, among whom 20 (39.2%) accepted effective preventive and control measures. The mangled extremity severity score between the two groups of patients had no significant difference (6.69±1.96 vs. 7.23±3.54, P>0.05). After being admitted into the hospital, the treatment group had one complication case of crush injury, while the control group had 10 complication cases including 7 of crush injury and 3 of amputation. The complication rate of the treatment group (5.0%) was significantly lower than that of the control group (32.3%, P<0.05). Conclusion Active and effective prehospital preventive and control measures are very important in the treatment of crush syndrome and reduction of morbidity, but the pre-hospital emergency personnel's knowledge of crush injury and crush syndrome is not enough.

Citation： ChenHuaixiang, TianHaiping, LiuXuejun. Analysis of Pre-hospital First Aid for 51 Cases of Crush Injury. West China Medical Journal, 2016, 31(1): 53-56. doi: 10.7507/1002-0179.20160013 Copy

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4.	Vanholder R, Sever MS, Erek E, et al. Acute renal failure related to crush syndrome:towards an era of seismo nephrology[J]. Nephrol Dial Transplant, 2000, 15(10):1517-1521.
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6.	Sever MS, Vanholder R, Lameire N. Management of crush related injuries after disasters[J]. N Engl J Med, 2006, 354(10):1052-1063.
7.	馬俊, 康鵬德, 裴福興, 等. 5·12汶川地震擠壓傷患者高鉀血癥的救治及相關因素分析[J]. 中國矯形外科雜志, 2009, 17(20): 1544-1546.
8.	Aoki N, Demsar J, Zupan B, et al. Predictive model for estimating risk of crush syndrome:a data mining approach[J]. J Trauma, 2007, 62(4):940-945.
9.	Oda J, Tanaka H, Yoshioka T, et al. Analysis of 372 patients with crush syndrome caused by the Hanshin-Awaji earthquake[J]. J Trauma, 1997, 42(3):470-476.
10.	康鵬德, 屠重棋, 黃富國, 等. 汶川地震所致肢體擠壓傷及擠壓綜合征相關危險因素分析[J]. 中華骨科雜志, 2008, 10(28):799-802.
11.	何慶, 楊旻, 姚蓉. 對地震擠壓傷院前急救的反思與思考[J]. 華西醫學, 2009, 24(4):968-970.
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1. Heifer DL, Howey T, Sanders R, et al. Limb salvage versus amputation:preliminary results of the mangled extremity severity score[J]. Clin Orthop Relat Res, 1990(256):80-86.
2. 范士志, 蔣耀光, 黃顯凱, 等. 現代創傷治療學[M]. 北京:人民軍醫出版社, 2009:206-208.
3. 盧世璧. 汶川地震擠壓綜合征患者肌肉擠壓傷的特點[J]. 中華骨科雜志, 2008, 10(28):793-798.
4. Vanholder R, Sever MS, Erek E, et al. Acute renal failure related to crush syndrome:towards an era of seismo nephrology[J]. Nephrol Dial Transplant, 2000, 15(10):1517-1521.
5. 徐衛東, 張春才, 李明. 地震災害傷員的擠壓傷早期處理[J]. 中國矯形外科雜志, 2008, 16(20):1532-1535.
6. Sever MS, Vanholder R, Lameire N. Management of crush related injuries after disasters[J]. N Engl J Med, 2006, 354(10):1052-1063.
7. 馬俊, 康鵬德, 裴福興, 等. 5·12汶川地震擠壓傷患者高鉀血癥的救治及相關因素分析[J]. 中國矯形外科雜志, 2009, 17(20): 1544-1546.
8. Aoki N, Demsar J, Zupan B, et al. Predictive model for estimating risk of crush syndrome:a data mining approach[J]. J Trauma, 2007, 62(4):940-945.
9. Oda J, Tanaka H, Yoshioka T, et al. Analysis of 372 patients with crush syndrome caused by the Hanshin-Awaji earthquake[J]. J Trauma, 1997, 42(3):470-476.
10. 康鵬德, 屠重棋, 黃富國, 等. 汶川地震所致肢體擠壓傷及擠壓綜合征相關危險因素分析[J]. 中華骨科雜志, 2008, 10(28):799-802.
11. 何慶, 楊旻, 姚蓉. 對地震擠壓傷院前急救的反思與思考[J]. 華西醫學, 2009, 24(4):968-970.
12. Better OS. The crush syndrome revisited(1940-1990)[J]. Nephron, 1990, 55(2):97-103.

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