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Prolonged Field Care > Crush Syndrome > Flashcards

Flashcards in Crush Syndrome Deck (14)
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1
Q

what is the considered the best tx for a patient with crush injuries in the PFC setting?

A

IV/IO crystalloids, immediately, initial 2L bolus @ 1L/h; adjust to UOP >100-200mL/h

2
Q

what are some options for fluids in the PFC setting for a crush injury when IV/IO fluids are not available?

A

oral intake of electrolyte solution

Rectal infusion of electrolyte solution (up to 500mL/h)

3
Q

What is the goal UOP in the crush injury patient?

A

100-200mL/h

4
Q

How can you evaluate for the presence of myoglobin in the urine if you do not have a lab available?

A

urine dipstick - erythrocyte/hemoglobin

monitor urine color

5
Q

what lab value represent hyperkalemia?

A

> 5.5 mEq/L

6
Q

What are some ECG signs that may indicate hyperkalemia?

A
sinus bradycardia
peaked T waves
lengthening PR interval
prolonged QRS interval
PVCs or runs of ventricular tachycardia 
Conduction block
7
Q

What is considered the best treatment for hyperkalemia in the PFC setting?

A

calcium gluconate
insulin + D50
albuterol
sodium polystyrene sulfonate

8
Q

How is calcium gluconate adminstered?

A

10mL (10%) IV over 2-3 minutes

9
Q

What is the onset of effect and duration of calcium gluconate?

A

immediate onset

duration 30-60 minutes

10
Q

How should insulin and glucose be administered?

A

10 units of regular insulin followed immediately by 50mL of D50 (onset 20 min, duration 4-6 hours)

11
Q

How is albuterol administered to the crush injury patient?

A

12mL of albuterol sulfate solution (0.083%) in nebulizer, onset 30 minutes, duration 2 hours

12
Q

how is sodium polystyrene sulfonate administered to the patient with a crush injury in the PFC setting?

A

15-30g suspended in 50-100mL liquid. oral or rectal.

13
Q

what is the onset and duration of soidum polystyrene?

A

onset >2hours

duration 4-6 hours

14
Q

what should be used to prevent injection in the crush injury patient in the PFC setting?

A

Ertapenem 1gm/IV/Day