Crush Syndrome in Disaster

摘要

Crush syndrome is a condition observed in patients who have been buried under collapsed buildings or rubble. It is characterized by rhabdomyolysis developing shortly after rescue and subsequent hyperkalemia, shock, acute renal failure, and other systemic symptoms. The development of acute renal failure can be avoided if fluid therapy is initiated early and diuresis can be induced. In severe cases, intensive care including hemodialysis, prevention of compartment syndrome, and infection control is effective in reducing the mortality. However, actual treatment involves considerable difficulties because we must deal with a large number of patients at the time of a disaster. Even in such demanding situations, we should be able to save the lives of as many patients as possible by predicting the development of crush syndrome, initiating fluid therapy as part of confined space medicine, practicing appropriate triage, and transporting patients to high-level medical institutions.