This protocol is for isolated crush injuries of extremities with an entrapment time of > 2 hours.
Patient care should be instituted IN CONJUNCTION with rescue efforts as long as safety of the rescuers is observed.
The patient should have the following:
a. Large-bore IV placement
b. Isotonic Solution (NS or LR) 0.9% NORMAL SALINE infusion at a wide-open rate
c. Continuous EKG monitoring
d. Oxygen
i. The risk of oxygen use must be weighed against the danger of fire in the extrication process and around power tools.
Immediately PRIOR to release of entrapped limb, administer SODIUM BICARBONATE 50 mEq IV push.
If the patient exhibits NEW widening of QRS (indicating hyperkalemia), administer CALCIUM CHLORIDE 10% 10 mL IV.
a. EITHER flush IV line that Sodium Bicarbonate was given through OR administer through separate IV line.
Treat pain per Pain Management Protocol.