What Is a Crush Injury?
A crush injury occurs when significant pressure or force is applied to a part of the body, typically from being squeezed between two heavy objects.
This type of trauma is often seen in industrial settings, road traffic accidents, and natural disasters.
The resulting damage can be extensive—affecting muscles, nerves, and bones—and, if not managed correctly, may lead to life-threatening complications.
Understanding the mechanism of injury and how to administer appropriate first aid is essential in minimising long-term harm and improving outcomes.
Common Causes of Crush Injuries
Crush injuries are typically the result of sudden accidents in environments where heavy machinery, equipment, or collapsing structures are present.
In industrial settings, limbs may become caught or trapped under moving parts of machinery. In the event of a natural disaster, such as an earthquake or building collapse, individuals can be pinned under fallen debris.
Road traffic collisions can also result in crush injuries, for example, when a person is pinned between two vehicles or crushed by a falling object.
These scenarios can happen unexpectedly and escalate quickly, making immediate first aid intervention essential.
First Aid Response: Immediate Action Saves Lives
What you do in the minutes following a crush injury can have a significant impact on a casualty’s chances of recovery.
Responding calmly, safely, and with the right knowledge can reduce complications and potentially save a life.
1. Ensure the Area Is Safe
Before approaching the injured person, confirm that there is no ongoing danger to yourself or others. Remove any hazards if it is safe to do so.
2. Call Emergency Services
Dial 999 immediately. Clearly describe the situation, the nature of the injury, and your location. Fast emergency response is vital.
3. If the Person Has Been Trapped for Less Than 15 Minutes
- Remove the crushing object as soon as it is safe to do so.
- Control any bleeding—apply pressure to wounds using clean dressings if available.
- Treat for shock: lay the person down and raise their legs slightly if there are no signs of injury to the spine or pelvis.
- Stay with the casualty, offering reassurance while monitoring their breathing and responsiveness.
4. If the Person Has Been Trapped for More Than 15 Minutes
- Do not release the object unless advised by emergency services.
- Inform 999 that the person has been trapped for an extended period. Ask directly: “Should we move them?”
- Keep the casualty still, warm, and calm.
- Monitor their condition continuously until professional help arrives.
Crush Syndrome: A Medical Emergency
Crush syndrome can develop when a limb or part of the body has been compressed for a prolonged time. The pressure causes muscle breakdown, leading to the release of toxins such as potassium, lactic acid, and nitric oxide into the bloodstream upon release of the pressure.
This sudden influx of toxins can result in:
- Hyperkalaemia – which may trigger cardiac arrest
- Metabolic acidosis
- Hypocalcaemia
- Acute kidney injury (AKI)
To reduce the risk of these complications, it is crucial not to release the crushing weight after prolonged entrapment unless directed by medical professionals.
Key Guidelines for Releasing a Trapped Person
- If possible, wait for emergency medical personnel to arrive before moving a casualty trapped for more than 15 minutes.
- Monitor vital signs such as breathing, consciousness, and circulation.
- If safe, elevate the injured limb to help reduce swelling and assist blood flow.
- Maintain a calm, reassuring presence to reduce shock.
When to Seek Immediate Medical Attention
All crush injuries, regardless of severity, require prompt medical evaluation. Emergency care is especially urgent if the casualty shows signs of:
- Severe or uncontrollable bleeding
- Shock – cold, clammy skin; rapid pulse; dizziness
- Breathing difficulties
- Unconsciousness or confusion
Early intervention and informed first aid can dramatically improve a casualty’s chances of recovery. Always prioritise calling for professional help and follow the guidance of emergency services.
