When bones are set and bleeding stops, earthquake victims face ‘crush syndrome’

After rescue workers are finally able to reach the victims of the Nepal earthquake and address their injuries, health-care workers will be watching carefully for two conditions that crop up later: “crush syndrome” and “compartment syndrome.”

The related problems, which are life- and limb-threatening, result from hours of compression of arm and leg muscles by rubble in earthquakes and building collapses. But doctors also see them in drug addicts and others who pass out with their heads on their arms, and surgical patients who aren’t positioned properly.

“Crush syndrome” is the more dangerous of the two; it can result in death. When earthquake victims with arm or leg injuries are pulled from the rubble, releasing the pressure on crushed muscles, blood begins to flow through the area again. As it circulates, it brings the byproducts of that damaged tissue to other parts of the body, which aren’t prepared to handle the toxins, according to Mark Pearlmutter, vice president of emergency medicine for the Steward Health System near Boston.

“As soon as you release the crush injury, or the rock, or whatever it might be, the blood flows back into your system,” said Pearlmutter, who spent four weeks in Haiti tending to victims of the 2010 earthquake there. “And with it is an abundance of broken down muscle byproducts.”

Myoglobin, a protein in muscle tissue, can flood the kidneys, causing them to fail days after the person is rescued and wounds are sewn up, Pearlmutter said. Excess potassium can disrupt the electrical signals that are critical to your heart beating rhythmically, causing it to fail, he said.

According to an article in The Bone and Joint Journal (www.bjj.boneandjoint.org.uk), 2 to 5 percent of earthquake victims will suffer crush syndrome.

In “compartment syndrome,” the inflammation of a crushed muscle causes so much swelling that the blood supply is cut off in the area around that muscle. Within hours, that muscle can die, if surgeons don’t release the pressure by cutting open the fascia, the thick lining that surrounds the muscle.

Victims also may go into shock in the first few hours after they’re pulled from rubble, often because of decreased blood volume as a result of their injuries and dehydration.

Pearlmutter, a member of the American College of Emergency Medicine who serves on a disaster response team, said he saw lots of post-injury infections because some victims did not receive treatment for five to seven days – including those with fractures that had pierced their skin. Partially as a result, he said, 6,000 people had limbs amputated after that quake, which killed 316,000 people, according to the Haitian government.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

Trader Joe’s customers walk in and out of the store on Monday, Nov. 20, 2023 in Everett, Washington. (Olivia Vanni / The Herald)
New Trader Joe’s opens this week at Everett Mall

It’s a short move from a longtime location, essentially across the street, where parking was often an adventure.

Ian Bramel-Allen enters a guilty plea to second-degree murder during a plea and sentencing hearing on Wednesday, March 6, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
‘Deep remorse’: Man gets 17 years for friend’s fatal stabbing in Edmonds

Ian Bramel-Allen, 44, pleaded guilty Wednesday to second-degree murder for killing Bret Northcutt last year at a WinCo.

Firefighters respond to a small RV and a motorhome fire on Tuesday afternoon in Marysville. (Provided by Snohomish County Fire Distrct 22)
1 injured after RV fire, explosion near Marysville

The cause of the fire in the 11600 block of 81st Avenue NE had not been determined, fire officials said.

Ashton Dedmon appears in court during his sentencing hearing on Tuesday, March 5, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
Everett Navy sailor sentenced to 90 days for fatal hit and run

Ashton Dedmon crashed into Joshua Kollman and drove away. Dedmon, a petty officer on the USS Kidd, reported he had a panic attack.

A kindergarten student works on a computer at Emerson Elementary School on Wednesday, Feb. 28, 2024, in Everett, Washington. (Ryan Berry / The Herald)
‘¡Una erupción!’: Dual language programs expanding to 10 local schools

A new bill aims to support 10 new programs each year statewide. In Snohomish County, most follow a 90-10 model of Spanish and English.

Cassie Franklin, Mayor of Everett, delivers the annual state of the city address Thursday morning in the Edward D. Hansen Conference Center in Everett, Washington on March 31, 2022.  (Kevin Clark / The Herald)
At Everett mayor’s keynote speech: $35 entry, Boeing sponsorship

The city won’t make any money from the event, city spokesperson Simone Tarver said. Still, it’s part of a trend making open government advocates wary.

Logo for news use featuring the Tulalip Indian Reservation in Snohomish County, Washington. 220118
Woman drives off cliff, dies on Tulalip Reservation

The woman fell 70 to 80 feet after driving off Priest Point Drive NW on Sunday afternoon.

Everett
Boy, 4, survives fall from Everett fourth-story apartment window

The child was being treated at Seattle Children’s. The city has a limited supply of window stops for low-income residents.

People head out to the water at low tide during an unseasonably warm day on Saturday, March 16, 2024, at Lighthouse Park in Mukilteo, Washington. (Ryan Berry / The Herald)
Everett shatters record high temperature by 11 degrees

On Saturday, it hit 73 degrees, breaking the previous record of 62 set in 2007.

Snohomish County Fire District #4 and Snohomish Regional Fire & Rescue respond to a motor vehicle collision for a car and pole. The driver was pronounced dead at the scene, near Triangle Bait & Tackle in Snohomish. (Snohomish County Sheriff’s Office)
Police: Troopers tried to stop driver before deadly crash in Snohomish

The man, 31, was driving at “a high rate of speed” when he crashed into a traffic light pole and died, investigators said.

Alan Dean, who is accused of the 1993 strangulation murder of 15-year-old Bothell girl Melissa Lee, appears in court during opening statements of his trial on Monday, March 18, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
31 years later, trial opens in Bothell teen’s brutal killing

In April 1993, Melissa Lee’s body was found below Edgewater Creek Bridge. It would take 27 years to arrest Alan Dean in her death.

Logo for news use featuring the municipality of Snohomish in Snohomish County, Washington. 220118
Man dies after crashing into pole in Snohomish

Just before 1 a.m., the driver crashed into a traffic light pole at the intersection of 2nd Street and Maple Avenue.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.