This is the podcast, Surgery I See Rounds. My name is Jeff Guy.

Lately, we have seen several events that resulted in production of numerous injuries very rapidly.

We're talking about the bridge collapse in Minnesota, the mine collapse in Utah, as well as another mine collapse in China.

Unique to these types of mechanisms is their ability to produce an injury pattern that's

not commonly seen in daily trauma care, but under situations of building collapses,

mine collapses, and earthquakes, it's a reasonably common mechanism

of injury, and that's the crush injury. Crush injuries are capable of producing something

obviously called Crush Syndrome, and this is also known as traumatic ravdomyalysis. It's a clinical

inaneity characterized by renal failure and death after severe muscle trauma.

Crush syndrome was first described in World War I when German soldiers rescued from collapsed trenches and then again in World War II in patients of the London Blitz.

In World War II, Crush syndrome had a mortality rate in the excess of 90%.

But during the Korean War, mortality rate was reduced to 84%. But after the advent of human dialysis, mortality rate was decreased to 53%.

In the Vietnam War, the mortality rate was approximately the same at 50%.

Now, myself, I'm trained in practice as a trauma surgeon and burn surgeon.

And when we think about mass casualty preparation,

certainly we commonly don't think about what is the role of having dialysis

and nephrologist as part of our emergency response teams.

But hopefully I want to introduce to you what is this crush syndrome and hopefully illustrate to you the necessity of when you're doing disaster planning for something like a building collapse or an earthquake that you really dial in the role of the nephrology teams and haemodialysis teams in saving lives.

We know that with previous earthquakes,

mass casualties have produced injuries

requiring basically a rapid response

on a significant scale of people trained in nephrology and dialysis.

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