References
External links
An academic presentation on gingival recession
Highly informative overview article from the NYTimes.
Immediate untreated crush syndrome death is caused by severe head injury, torso injury with damaged abdominal organs, and asphyxia (excessive loss of oxygen). Early untreated crush syndrome death is caused by hyperkalemia and by hypovolemic shock. Late untreated crush syndrome death is caused by renal failure, coagulopathy and hemorrhage, and sepsis.Due to the risk of crush syndrome, current recommendation to nonprofessional first-aiders (in the UK) is to not release those with a crush injury who have been trapped for more than 15 minutes. Treatment consists of not releasing the tourniquet, overloading the patient with fluid using Dextran 4000 IU, and slow release of pressure. If pressure is released during first aid, then fluid is restricted and an input-output chart for the patient is maintained, and proteins are decreased in the diet. Field management
As mentioned, permissive hypotension (restrictive fluid therapy) is unwise. Careful fluid overload and administration of intravenous sodium bicarbonate is wise, especially if the crushing weight is on the patient for more than 4 hours, but often if it persists more than one hour. The San Francisco emergency services protocol calls for a basic adult dose of a 2 L bolus of normal saline followed by 500 mL/h, limited for "pediatric patients and patients with history of cardiac or renal dysfunction. "Use of a tourniquet can stall the life-threatening consequences of a crush related injury and can be a second option if the person cannot immediately have the fluids that were lost be medically replaced back into the body.