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Special Article |

Crush Syndrome: Saving More Lives in Disasters:  Lessons Learned From the Early-Response Phase in Haiti

Carmi Bartal, MD, MPH; Lior Zeller, MD; Ian Miskin, MD; Gilbert Sebbag, MD; Erez Karp, MD; Alon Grossman, MD; Anat Engel, MD, MHA; Dan Carter, MD; Yitshak Kreiss, MD, MHA, MPA
Arch Intern Med. 2011;171(7):694-696. doi:10.1001/archinternmed.2011.122.
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The Israel Defense Forces Medical Corps Field Hospital was fully operational 89 hours after the Haiti earthquake in January 2010. In earthquake scenarios, crush injuries are a major cause of death. The incidence of crush syndrome can be as high as 25% in earthquake victims. Acute renal failure (ARF), a complication of crush syndrome that is commonly encountered in the first days following earthquakes, has an excellent outcome when renal replacement treatment (RRT) is available.1 The incidence of ARF related to crush syndrome depends on the intensity of the earthquake and the amount of time spent under rubble, and ranges from 0.5% to 25%. More than half of those with renal failure will require RRT.2

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Flowchart of a proposed stratified approach to the management of acute renal failure (ARF) in patients with crush syndrome in the very early phase of disaster environment. IV indicates intravenous.

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