Crush injuries

Crush injuries occur when a part of the body, such as a hand, arm, leg, foot or trunk is trapped, pinched or jammed under or between objects. The pressure can harm skin, muscles, nerves or bone, depending on the degree of force. In some cases little damage is seen on the outside as the damage is hidden on the inside.

Crush injuries are common on farms, particularly those involving the hands. The most serious cases occur in agriculture where heavy machinery is used and people become trapped under them or in them.

Crush injuries can happen:
•    During tractor and quad bike rollovers
•    While using heavy equipment
•    When moving large hay or wool bales
•    While dealing with animals in yards or small spaces
•    During logging or cutting firewood
•    While moving farm equipment.

Crush injuries can cause compartment syndrome or crush injury syndrome which both have serious consequences. Both require urgent medical attention.

Compartment syndrome
Compartment syndrome can occur when muscles inside the ‘compartment’ of a limb swell so much that blood flow is blocked. The fascia, which covers the muscles, is not very elastic and does not stretch, forcing the pressure from the swelling inwards, compressing nerves and blood vessels. This compression can damage nerves and muscles, causing chronic pain and mobility issues. Compartment syndrome can be caused by many things including being crushed under a heavy object.

Crush injury syndrome
Crush injury syndrome occurs when a large area of muscle is compressed and starved of blood flow over several hours. This causes the muscle cells to break down, releasing acids and other chemicals. When the pressure is removed these chemicals are released and can cause serious damage as they travel to the heart and kidneys.

First aid
First aid for crush injuries requires careful assessment.  If the area has been compressed for a long time it may be best to wait for emergency services to arrive, or seek advice when you call Triple Zero (000), before removing the crushing weight, as a tourniquet or intravenous fluids may be needed before the weight is released.

However, if the weight on the head, chest, neck or abdomen is not removed the casualty may die from breathing failure, heart failure or blood loss. Even if not apparently badly injured internal damage or rapid deterioration can occur. Seek medical attention.

Find out more about this topic on Better Health Channel, for suggestions to prevent crush injuries involving tractors, quad bikes, machinery, grain augers, and livestock.

Fast facts:

• Crush injuries, where part of the body is squeezed between or under a heavy object, are common on farms and can be serious.
• Crush injuries can cause broken bones (fractures) bruising and bleeding.
• Crush injury syndrome occurs when a large area of muscle is squashed, this requires careful first aid, call triple zero 000 immediately for advice before you ‘free’ the person.