Unconscious overdose patients are probably more likely to develop "crush
syndrome" rather than compartment syndrome
Many similarities in that dead muscle is produced but surgery is not
recommended as the damage is patchy and there is a chance of recovery. MRI
scans produce interesting pictures in these patients. If operated on it is
not obvious what to remove and what to leave behind and infection is a
common complicaton.
Treatment aims to prevent/manage the renal failure and acidosis secondary to
myoglobinaemia.
We had a spectacular example when a drunk/drugged fisherman was retrieved by
helicopter after lying on the floor of a cabin overnight
His right buttock was enormous due to swelling of his crushed gluteous
maximus and it looked as though it would benifit from incision to release
the pressure!
He was acidotic with impaired renal function. Treated conservatively and
made a full recovery.
However I suppose in cases where the crushed part has a compartmental
structure such as the forearm some might benefit from fasciotomy
Q. The commonest cause of "crush syndrome" in Australasia is?......
A. Drug overdose
JohnC
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Thursday, December 14, 2000 10:20 PM
To: [log in to unmask]
Subject: Re compartment syndrome
No references I'm afraid. I was involved in fatal case where an IV herion
user
had been lying on the floor for about 36 hours, with an arm bent under him.
He developed a compartment syndrome in his forearm, with no bony injury.
This
contributed, with other medical problems, to his death.
Adrian Boyle
SPR East Anglia
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