Paramedic National Registry Practice

What is the primary concern when treating a patient with signs of crush syndrome?

1. Preventing hypothermia

2. Managing fluid balance

3. Reestablishing circulation to affected areas

4. Monitoring respiratory rate

The correct answer is: Reestablishing circulation to affected areas

The primary concern when treating a patient with signs of crush syndrome is reestablishing circulation to affected areas. Crush syndrome occurs when muscle tissue is damaged due to prolonged compression, leading to cell death and the release of myoglobin and other harmful substances into the bloodstream. One of the most critical aspects of management is alleviating the compression to restore blood flow to the affected muscle tissue. This can help to prevent further tissue damage and support the recovery of the affected areas. Timely reestablishment of circulation is essential to minimize complications such as kidney damage from the debris released during the muscle breakdown process. The swift restoration of blood flow can help limit the systemic effects of toxins released into the body, thereby reducing the risk of serious effects on multiple organ systems. While fluid balance is significant in the overall management of crush syndrome, especially to prevent acute kidney injury due to myoglobinuria, it becomes secondary to the immediate need to restore circulation and relieve the compression. Preventing hypothermia and monitoring respiratory rates are important aspects of patient care but are not as direct a concern as the need to restore perfusion to the damaged tissues in crush syndrome.