![]() When you, for example, run a mile, lactic acid builds up, which ends up causing your pace to slow down. It’s the reason why we lose our steam when it comes to exertion. The body doesn’t enjoy this, because it’s irritating. When the body begins to exert energy-or when muscle cells are damaged-a biproduct is lactic acid. The human body runs a little on the alkaline side of the pH scale, normally measuring 7.35–7.45. If you have the ability, collect 12-lead EKGs as soon as you can and then every 30 minutes to continuously monitor for hyperkalemia. Pretreatment for hyperkalemia (high potassium) consists of giving the patient calcium chloride as well as continuous albuterol treatments to push the potassium back into the muscle cells.Ī sign of hyperkalemia are tall T waves on a 12-lead EKG. Large amounts of potassium can place the heart into cardiac arrest or other cardiac arrhythmias. When it’s released in great volumes into the circulatory system, it can have a profound effect on the heart. Potassium is an intracellular-based electrolyte that assists with muscle contractions. So, what do we do about it? TreatmentsĮMTs and paramedics must understand all of these elements that are in the nasty swamp of a distal extremity. The mistake that’s made and ultimately takes the life of the patient is blowing up the dam (removing the crushing object) too soon. On the proximal side of the “dam” is that beautiful, bright, crystal blue water that is the rest of the vasculature of the body. In the body, potassium is the feces, lactic acid is the algae and myoglobin is the bacteria, and the “swamp” forms on the distal end of the extremity. (The dam equates to the crushing object at the incident.) The backed up water in the creek becomes stagnant.īiproducts of the damaged creek, such as animal feces, algae and bacteria, build up to create a nasty, swamp-type environment. Then those pesky beavers build a dam across the creek, which causes some serious backup of the flowing water. We can think of it with this analogy: Imagine that the body’s vascular system is a beautiful, flowing creek. The most important of these leaked substances are potassium, lactic acid and myoglobin. When the muscle cells are damaged, the resulting effect is that they release/leak numerous substances. When an object crushes the extremities and tissues, it damages the muscle cells themselves. However, critical levels of the following elements really start to pose a serious threat an hour or more after the injury. Remarkably, crush syndrome can start in as little as 20–30 minutes after an injury occurs. Potassium, other substancesĬrush syndrome derives from crush injuries that involve soft tissue, primarily skeletal muscle of the extremities. I don’t want you to be in the shoes of not knowing, because this is a very, very big deal. Thankfully, my paramedic partner knew what was going down. In fact, I didn’t learn about this until I was faced with it as an EMT. I have had numerous conversations with EMTs and paramedics who had absolutely no idea what crush syndrome, or rhabdomyolysis, is. What is crush syndrome? What we can do about it when we’re confronted by it on scene? Crush syndrome isn’t discussed much in the limelight of EMS nor in classes that we take to prepare for the lifesaving career that we selected.
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