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                               CRUSH INJURIES
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     These injuries often involve damage to a great deal of skin, muscle
     and bone and medical aid should ALWAYS be sought. There may be 
     serious external and internal bleeding. In particular, there may
     be damage to the blood vessels supplying a limb, therefore, if
     release and rescue are delayed, the part may be lost due to a lack
     of oxygenated blood. In some cases, where the part remains crushed
     for over an hour, serum will pour into the injured tissues causing
     them to become swollen and hard, blood pressure will drop and shock
     will develop.
 
     There wil be also an accumilation of toxic chemicals within the 
     body because of substances released by the damaged muscle. On 
     release from this crushing, these substances can flood back to the
     rest of the body causing kidney failure which can be fatal.

     Therefore, although a casualty may show little sign of injury when
     released, except redness and swelling, a serious condition may be
     present.

     
     The Aim
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     Prevent damage to the kidneys cause by the release of toxic 
     chemicals. In all cases where the casualty has been trapped for 
     more than 30 minutes, call the Emergency Services BEFORE attempting
     release.


     Treatment
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     1: Control serious bleeding and treat any wounds; immobilise
        fractures as far as possible. ( see Part 2 Fractures )

     2: If the trapped limb can be released without delay, remove the
        weight. Keep the casualty lying down with the head low and legs
        raised where possible. Advise the casualty not to move.

     3: Immobilise the affected limb using pillows and rolled up 
        clothing or blankets, and if injuries allow, elevate limb. Where
        possible, crush injuries should be left uncovered.

     4: Minimise shock. ( see Circulation )

     5: Check breathing rate, pulse and levels of responsiveness at 10
        minute intervals.

     6: If the casualty becomes unconscious but is breathing normally,
        place in the Recovery Position. ( see Resusitation )

     7: If breathing and heartbeat stop, begin resusitation immediately.

     8: Remove to hospital immediately. Transport as a stretcher case
        maintaining the treatment position; notify the Ambulance Crew
        of the duration of the crushing.

    
     IF - removal to hospital will be delayed by more than 30 minutes
     and internal injury is not suspected, give the casualty cold SIPS
     of water.

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