This module will focus on a talk given by the incoming 1st SFC Surgeon Dr. Jamie Riesberg on Crush Syndrome. We have also provided the CPG for Crush Syndrome for your review. Finally, we have provided a link to a post discussing the fact that many physicians are dubious of the role of Kayexalate in the management of severe hyperkalemia, and which discusses the use of diuretics for the removal of potassium from the body.
Please also visit the link regarding hyperkalemia changes on EKGs, and make sure you understand what they mean when they discuss peaked T waves and widened QRS.
TLOs:
Recognize crush injury
Understand immediate first aid for crush injury
Recognize the metabolic derangements that can occur with crush injury
Manage the sequelae of crush injuryBe aware that Kayexalate is a controversial medication
Be aware that many physicians will recommend diuretic use for management of hyperkalemia
Have familiarity with the EKG changes associated with hyperkalemia and be able to identify them with the help of references.
Primary materials:
https://prolongedfieldcare.org/2016/08/23/crush-syndrome-from-a-prolonged-field-care-perspective/
https://litfl.com/hyperkalaemia-ecg-library/
Kayexalate Controversy and Beyond:
https://rebelem.com/kayexalate-useful-treatment-hyperkalemia-emergency-department/
https://emcrit.org/pulmcrit/management-of-severe-hyperkalemia-in-the-post-kayexalate-era/