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Control measure

Release of a casualty with crush injury

Control measure knowledge

The casualty should be released as quickly as possible, irrespective of the length of time trapped. Consideration should be given to the possibility of a spinal injury, and full spinal precautions should be taken.

If personnel are extricating a casualty with crush injuries, it is important that they accurately communicate the status of the casualty to medical responders. It may also be necessary to assist medical responders or to provide casualty care by following their instructions.

Amputation should only be considered if the casualty’s survival is in danger due to entrapment by a limb. Expert advice and advanced medical support will be required for surgical release, and they should be mobilised early.

If the casualty has a crushed limb, the application of a tourniquet by trained personnel may be appropriate to stop bleeding. However, there is no evidence that crush syndrome can be reduced by the application of tourniquets.

For further information refer to The Faculty of Pre-Hospital Care publication, Consensus Statement on the Early Management of Crush Injury and Prevention of Crush Syndrome.

Strategic actions

Fire and rescue services should:
  • Understand whose assistance should be requested if surgical release of a trapped casualty may be required

Tactical actions

Incident commanders should:
  • Communicate the status of the casualty with a crush injury to medical responders

  • Assist medical responders treating a casualty with a crush injury

  • Request advanced medical support if surgical release of a trapped casualty may be required