Tuesday, April 28, 2015

Prevention and treatment of acute kidney failure due to crush injury after natural disasters - a field guide

After head injuries and bleeding, the medical staff need to watch for and prevent hyperkalemia (causes arrhytmias), myoglobinuria and myoglobinemia (cause acute renal failure), hyperphospatemia, hypocalcemia, acidosis and later on, onset of compartment syndrome in victims of crush injuries whose muscles were crushed or compressed by rubble. These can begin to set in soon after extrication of the victim from rubble when circulation is restored, and the intracellular potassium and myoglobin from crushed tissue enter the circulation.

Follow the field guide produced by the International Society of Nephrology Renal Disaster Relief Task Force, published in the journal Nephrology Dialysis Transplantation(2012). Screenshots of relevant flowcharts embedded as images for quick reading. The information here is reproduced with kind permission from the International Society of Nephrology.




Step 1. IV or subcutaneous fluids before extrication under the rubble 
(avoid potassium containing fluids)

Step 2. Primary Survey in the Field

Step 3. Assessment in the Field

Step 4. Treatment after Extrication

Table: IV fluids for use in Crush Victims

Recommendations for the management of crush victims in mass disasters, short field version, by the International Society of Nephrology Renal Disaster Relief Task Force (published in Nephrology Dialysis Transplantation, 2012; vol 27, suppl 1). PDF file with the treatment guidelines.

6 comments:

  1. what about "Acetaminophen protects kidneys after muscle injury"
    http://www.sciencedaily.com/releases/2010/02/100201171406.htm

    ReplyDelete
  2. Hey, thanks for posting such a good article. Total Cleanse Detox Diet is a firm which mindful everyone about their eating regimen plan to keep strong by including clusters of water and fluids in your timetable. To keep sound and clean your kidney through kidney cleanse diet or drinks heaps of water and various fluid materials in your step by step diet. This strategy will similarly help your kidney from stomach related afflictions like kidney stones et cetera.

    ReplyDelete
  3. I ɑm sure this post has touched all tҺe internet people, its really really good piecе
    of writing on building up new weblog. Cara Mengobati Gagal Ginjal

    ReplyDelete
  4. Nice blog and we know that 2015 is huge disaster year for Nepal and then Patanjali rahat kosh has been made to work Nepal trasdi help in that Further more This Trust did a recognizable work for Nepal earthquake victims. For more information please visit site: - patanjali Disaster Management

    ReplyDelete
  5. This is inspiration for those who are working for Nepal earthquake and providing help for those victims. For more information Please visit my site: -http://www.patanjaliyogpeethnepal.org/events/gallery/personality-development

    ReplyDelete
  6. ALL THANKS TO DR JOHNSON WITH HIS HERB I WAS CURED FROM A TERRIBLE NEPHROSIS DISEASE BY DR JONSON
    Is my pleasure to comment on this site and I thank the admin of this site
    for his/her great work so far.
    I really don’t know how to thank Dr Johnson
    for helping me get cured for over 25 year of suffering from
    this terrible Disease, this Illness started when I was 22 year I thought there was no cure, but even get worse as days went by,i have tried all western drugs prescribed by doctors but to no avail I lost total concentration,I
    came across DR Johnson contact through a headline news on internet about
    how DR Johnson have help so many people to get cured of various Diseases, and so many other with similar problem I contacted him and he told me how to get his herb,few day later he sent me the herbal portion which my husband paid for me, I always take the medicine every morning for One Month and his medicine was able to restore me back to normal I also went for a text, there so no more loss of protein from the plasma into the urine due to increased glomerular permeability, and now am very much okay without any side effects whatsoever If you have any Health problem you can contact him on his email address drjohnson958@gmail.com

    ReplyDelete