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This week's featured articles

7/15/2022

Management of Severe Crush Injuries in Austere Environments: A Special Operations Perspective

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Anderson JL, Cole M, Pannell D. 22(2). 43 - 47. (Journal Article)

Abstract

Crush injuries present a challenging case for medical providers and require knowledge and skill to manage the subsequent damage to multiple organ systems. In an austere environment, in which resources are limited and evacuation time is extensive, a medic must be prepared to identify trends and predict outcomes based on the mechanism of injury and patient presentation. These injuries occur in a variety of environments from motor vehicle accidents (at home or abroad) to natural disasters and building collapses. Crush injury can lead to compartment syndrome, traumatic rhabdomyolysis, arrythmias, and metabolic acidosis, especially for patients with extended treatment and extrication times. While crush syndrome occurs due to the systemic effects of the injury, the onset can be as early as 1 hour postinjury. With a comprehensive understanding of the pathophysiology, diagnosis, management, and tactical considerations, a prehospital provider can optimize patient outcomes and be prepared with the tools they have on hand for the progression of crush injury into crush syndrome.

Keywords: crush injury; Special Operations Medicine; tactical medicine; compartment syndrome; rhabdomyolysis

PMID: 35639893

DOI: 2Y7A-IGK7

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Prehospital Traumatic Brain Injury Management Clinical Pearls and Pathophysiology

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Ditzel RM, Hwang BY, Schmid JH, Ling GS. 22(2). 55 - 61. (Journal Article)

Abstract

Traumatic brain injury (TBI) management is complex. The brain is a sensitive, high-maintenance organ that loses its ability to take care of itself upon injury, and our primary mission is to achieve and maintain optimal levels of cerebral blood flow (CBF) from the moment of injury until recovery. The authors provide a case and discuss prehospital patient management, including adequate oxygen saturation and blood pressure, early recognition of TBI, frequent exams, detailed charting and hand-off, and fast transport to the next echelon of care.

Keywords: traumatic brain injury; pathophysiology; prehospital management; critical care

PMID: 35639895

DOI: 8AMI-B6SP

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