Crush syndrome ! rhabdomyolysis ! Muscles injury(Hindi) скачать в хорошем качестве

Crush syndrome ! rhabdomyolysis ! Muscles injury(Hindi)

#rhabdomyolysis, #Crush Syndrome, #crush muscles, #myoglobine, Cancer Therapy .Decision Support in Medicine » Critical Care Medicine Critical Care Medicine Crush Injury, Crush Syndrome, Traumatic Rhabdomyolysis, Muscle Reperfusion syndrom 1. Description of the problem Crush injury is a direct injury resulting from the crush. Crush Syndrome is the systemic manifestation of muscle cell damage resulting from pressure or crushing. Initially described by Bywaters and Beall in 1941in a patient who initially appeared to be unharmed but subsequently died of renal failure. Crush Injury: Compression of extremities or other parts of the body that causes muscle swelling and/or neurological disturbances. Crush Syndrome: Crush injury with systemic manifestations. Systemic manifestations are caused by a traumatic rhabdomyolysis due to muscle reperfusion injury when compressive forces on the tissues are released.This can cause local tissue injury, organ dysfunction, and metabolic abnormalities, including acidosis, hyperkalemia, and hypocalcemia. Clinical features Some or all of the following clinical signs and symptoms may be present: Cardiovascular instability Hypotension and hypovolemic shock. This may be caused from the massive fluid shift from the extracellular fluid space into the damaged cell s or associated injuries causing blood loss. Arrhythmia and negative inotropy secondary to hyperkalemia, hypocalcemia and hyperphosphatemia Cardiomyopathy Renal failure Secondary to circulatory shock and intravascular volume depletion leading to renal cortical ischemia. Release of myoglobin, urate, phosphate and purine by the muscle cells causes precipitation in the distal convoluted tubules, causing tubular obstruction. Metabolic acidosis with lactic acidosis Disseminated intravascular coagulopathy Hypothermia Myoglobinuria Skin injury and swelling Paralysis and paresthesia Pulses may or may not be present. Compartment syndrome Acute lung injury ARDS Key management points Primary survey with focus on airway, breathing and circulation. Establishing intravenous access and initiation of fluid resuscitation prior to releasing the crushed extremity, especially if the time of entrapment is 4 hours. If extrication is impossible short-term use of tourniquet on the affected limb is recommended until intravenous access can be obtained. Acute limb amputation should be avoided until extrication is impossible. Continue with fluid resuscitation while transfer to a medical facility is initiated. Monitor the crushed limb for the 5 p.Pain, Pallor, Paresthesia, Pain with passive movement and Pallor. Combat hypotension with aggressive hydration. Prevention of renal failure is important. Alkaline diuresis and mannitol therapy is recommended. Hemodialysis is also recommended for acute renal failure. Electrolyte abnormalities hypokalemia hypocalcemia hyperphosphatemianeed to be monitored and treated accordingly. Monitoring for cardiac arrhythmia is recommended. Correction of acidosis with alkalinization of the urine is critical. Newborn assessment! Apgar- in hindi 👉    • Newborn assessment ! Apgar for newborns ! ...   bronchoscopy with types of endoscopy Live 👉   • Видео   tonsil stones removal throat Surgery Live 👉   • tonsil stones removal throat, how remove t...   Neonatal resuscitation in hindi Live 👇👇    • Видео   O kallo m shadi tose kar leti got mummy ko song-    • Видео   Live demo of stethoscope use.👇👇    • How to use a stethoscope ! स्टेथोस्कोप का ...   Cannulation technique click here 👇👇👇 👉👉    • #कैनुला लगाने का तरीका,Cannulation Inserti...   माइग्रेन(आधे सिर का दर्द) इलाज यहाँ click करें-   • Migraine headache,headache,आधा सी सी दर्द ...      • खजूर खाने के ये 5 चमत्कारी फायदे।  Hindi      • Migraine headache,headache,आधा सी सी दर्द ...   Disclaimer :- Dear subscriber This information is based on collected data and you well understand before using any content and any type of medication so you consult with our doctors ....if you not sensitive and carefully read this information so we will not be liable for that. Thank-you. #Healthy tips Doctor