Exploring the wilderness is an exciting prospect for any outdoors enthusiast. Unfortunately, even when you take all the precautions possible, there’s always a risk of injury when you’re out hiking in the wild—you simply can’t control your surroundings. One such injury that can occur is crush syndrome.
While this injury can’t be treated fully outside of a hospital, there are things you can do to reduce the damage and risk of devastating outcomes if you happen to find yourself dealing with a crush injury far from civilization. Let’s go over everything the wilderness enthusiast needs to know about how to treat crush syndrome.
What Is Crush Syndrome?
Crush syndrome is a separate phenomenon from a crush injury. While it often begins with a crush injury, it quickly becomes something far more severe.
Damage begins at the cellular level, with the weight of the object causing immediate injury. After about an hour, circulation to the area decreases…and with it, the oxygen supply.
This forces the cells to adapt to their new environment, and anaerobic metabolism occurs, leading to a buildup of lactic acid. Without sufficient oxygen, cells lose the ability to hold onto their contents, and they begin to leak, causing further damage to the surrounding cells.
The content of cells contains potassium along with several other toxic substances; when these substances are released suddenly into the body (when the object causing the compression is moved without proper stabilization of the victim, for example), they can cause renal failure, liver damage, breathing problems, and cardiac issues.
What Causes Crush Syndrome?
Crush syndrome occurs when someone has been pinned beneath something heavy—such as a fallen tree, a tipped boat, a boulder, or another overwhelmingly weighty object—and ends up trapped for an extended period of time.
Crush syndrome can occur after as little as an hour of being trapped, though it more commonly occurs after four or more hours of being pinned beneath whatever object has “crushed” the victim.
Crush syndrome also isn’t commonly seen when a smaller extremity is pinned, such as an arm or hand—it’s often a result of larger areas of the body being trapped beneath the weight, such as the legs, pelvic area, or chest cavity.
Symptoms of Crush Syndrome
The symptoms you need to watch out for when assessing someone for crush syndrome are as follows:
- Loss of pulse in the trapped portion of the body
- Swelling and tension present in the trapped portion of the body
- Signs of shock—nausea, disorientation, vomiting, cold/clammy skin, fluttering/rapid pulse
The Dangers of Crush Syndrome
No matter what instinct may tell you—or how much the victim asks for it—resist the urge to remove the crushing object if it has been more than 10 minutes or so.
If you can remove the object quickly and efficiently, do so, but if you remove it any later than that, it could cause far more severe symptoms by releasing those aforementioned damaged cells into the rest of the body.
As mentioned, if you remove the crushing object before the victim has been properly stabilized by medical staff, it can cause renal failure, liver damage, breathing problems, and even sudden cardiac arrest.
While crush syndrome may cause these symptoms eventually regardless of whether the object has been removed, the process is slowed if you leave it be and wait for medical help.
How to Treat Crush Syndrome in the Wild
The most important factor in treating crush syndrome is gaining what’s known as “venous access,” or access to the bloodstream, in order to provide fluids to avoid kidney damage. This should be achieved before finding a way to release the trapped area of the body, but this is also something only trained medical professionals can achieve.
So what can you do to help someone suffering from crush syndrome as you wait for help?
Firstly, before attempting any type of assistance or rescue, ensure that the area is safe to approach and will remain safe as you work. If you’re injured in the process of giving aid, not only will you no longer be capable of helping the victim, but emergency services will now have two patients instead of one to worry about.
Secondly, do your best to stay safe in terms of hygiene—if you have gloves, make sure you put them on, or find some way to protect your hands. Especially do your best to be cautious if there’s a lot of blood.
Thirdly, remember your ABCs, or at least the ABs—Airway and Breathing. You can’t do much about the Circulation portion of this mantra at this point, but one of the first things you should do here is to ensure the victim’s airway is clear. If you know how to perform a jaw thrust maneuver (and you should if you plan to be trekking through the wild!), this is the best way to clear the airway.
Fourthly, your new top priority is preventing or treating the victim’s state of shock. The shock of the injury is just as likely to kill the victim as the other dangerous effects of crush syndrome. To treat shock, keeping the victim’s body warmed up is essential.
It’s also recommended that you elevate their legs (if possible) about twelve inches, but only if you’re reasonably certain their spine wasn’t damaged.
How to Get Help Quickly
It is extremely important to carry signaling equipment with you when you’re hiking and camping far from civilization.
Never take your safety for granted on any trail, even the more popular ones—you never know when you might end up lost, injured, or trapped, and it’s utterly vital you have some way to reach out and contact help if your phone is unable to pick up a signal.
You can carry flares, signaling mirrors, whistles, or even a personal locator beacon.
Final Thoughts on How to Treat Crush Syndrome
Ultimately, the best thing you can do in these survival situations is to stay calm, stay prepared, and do your research! Crush syndrome isn’t the only danger out there—to learn more about safety in a survival situation, visit our safety section now.