Thoracic Crush Injury After Natural or Man-Made Disasters

Thoracic crush injury is unique compared to other mechanisms of injury in that patients are more likely to present with greater numbers of rib fractures, bilateral rib fractures, flail chest, acute respiratory failure, as well as other thoracic cage fractures. Related complications are common including early acute kidney injury, blunt cardiac injury, and, on occasion, on-scene traumatic asphyxiation. Finally, some patients may develop crush syndrome which is the systemic manifestation of the unique direct impact, ischemia, and reperfusion noted in those with crush injury. Clinicians caring for injured patients should be aware of the implications of crush syndrome such as rhabdomyolysis, compartment syndrome, or acute respiratory distress syndrome in order to surveil for such complications, rapidly diagnose them when they occur, and plan to effectively treat them to optimize outcome.