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CRUSH SYNDROME ICD 10: T79.5

CRUSH SYNDROME ICD 10: T79.5. Mohit Chhabra Roll no. : 47. OBJECTIVES. Define and understand the pathophysiology of Crush Syndrome Clinical diagnosis and relevant investigation Management. A Case of Crush Syndrome…. Clinical Features.

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CRUSH SYNDROME ICD 10: T79.5

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  1. CRUSH SYNDROMEICD 10: T79.5 MohitChhabra Roll no. : 47

  2. OBJECTIVES • Define and understand the pathophysiology of Crush Syndrome • Clinical diagnosis and relevant investigation • Management

  3. A Case of Crush Syndrome….

  4. Clinical Features • Lower limb injury with pain and swelling, which later on developed anesthesia and motor disturbance • Signs of hypovolemic shock • Tea-colored urine, maybe oliguria • Nausea and confusion Pathophysiology

  5. On Investigating further…. • Hyperkalemia & hypocalcaemia • ECG changes secondary to hyperkalemia • Metabolic acidosis • Raised Creatine Kinase • Elevated UREA and CREATININE • Myoglobinuria • Evidence of D.I.C.

  6. Diagnosis: Crush Syndrome Definition: • A severe, often fatal condition that follows a severe crushing injury, particularly involving large muscle masses, characterized by fluid and blood loss, shock, hematuria, and renal failure. Also known as compression syndrome.(McGraw Hill Dictionary) • In a nutshell: TRAUMATIC RHABDOMYOLYSIS due to crushing • Also known as Bywaters Syndrome/ Reperfusion injury

  7. PATHOPHYSIOLOGY Clinical Features

  8. KIDNEY IS IN DANGER AS SOON AS WE RELIEVE THE COMPRESSION Renal hypoperfusion + Renal Tubular Necrosis = Renal Failure

  9. MANAGEMENT • Initial Management: • Follow the usual criteria of A-B-C as injuries are massive and high chances of poly-trauma • Early and rapid rehydration • Venous access preferably before the limb is decompressed • CVP and urinary catheterization for monitoring

  10. Further Management • Large amount of saline infusion with forced diuresis • Debridement of crushed tissue and a fasciotomy for compartment syndrome • Dialysis if renal failure sets in • Amputation as the last resort if massive limb injury is there and we have to prevent crush syndrome

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