Hello, you're listening to the podcast Surgery, ICU rounds. My name's Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the Regional Bird Center at Vanderbilt University Medical Center in Nashville, Tennessee.

The topic that I'm choosing to talk today about is crush injury and traumatic rhabdomyalysis as well as myoglobinuria.

Those of you have been following the sequence of the

podcast, know that our last podcast was on myocardial ischemia, which part one, and we are due to do a

part two podcast, but we're going to come back to that at a later date. I had to give a talk on this topic

today, and I felt it was appropriate to record this to a podcast and to push it out.

Starting with the topic of Crush Syndrome, it was initially described back in World War I,

and a physician named Meyer Betts described a syndrome of muscle pain, weakness, and brown urine.

It was typically seen in German soldiers who were buried and rescued subsequent from the trenches.

You remember, obviously, the trench warfare of World War I.

We also saw a crush syndrome type picture in the Battle of Britain,

and those people who were in London and survived the bombing of London and were

trapped in the rubble there as well. There are other settings that we see currently in more

modern society, typical of mind collapses. We've had several mind collapses here within the

United States and somebody who's been in a mine collapse, maybe trapped by their legs, is at risk for a crush syndrome.

Also, people who have been victims of severe beatings, victims of earthquakes and have been found under the rubble, landslides, building collapses, either through explosions or just earthquakes, alcohol and drug

intoxication, people who have been rendered unconscious by drugs or alcohol and are basically

found in one position for a prolonged period of time will begin to have muscle breakdown

and traumatic

rhabdomyalysis.

Other types of injuries where we may say severe raldomyalysis, particularly in Burt patients,

...