Emergency Case Management of Crush Syndrome and Rhabdomyolysis Following Earthquake Disasters

Abstract

Earthquakes are catastrophic events causing large-scale destruction and high mortality, with a significant risk of crush syndrome and rhabdomyolysis among individuals trapped under debris. This study examines the prehospital emergency management of crush syndrome and rhabdomyolysis following earthquakes. A comprehensive review was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for studies published in English and Turkish between January 1, 2018, and December 10, 2025. Out of 3,439 initially identified publications, 1,229 remained after year-based filtering; ultimately, 25 studies meeting the inclusion criteria were evaluated in full text. Findings indicate that early fluid resuscitation, electrolyte monitoring, hyperkalemia management, and controlled reperfusion are vital to reducing mortality. Initiating intervention before extrication significantly decreases the likelihood of acute kidney injury and fatal arrhythmias. The review demonstrates that time-sensitive field management, accurate triage, and decisive actions—such as indicated field amputations—are critical components of disaster response. In conclusion, the successful management of crush syndrome and rhabdomyolysis depends primarily on early recognition, field-adapted protocols, personnel training, and team coordination rather than advanced treatment capacity. The preparedness of prehospital emergency teams and the implementation of standardized intervention algorithms are key determinants in reducing mortality in disaster settings.

Keywords

• Earthquake
• Crush Syndrome
• Rhabdomyolysis
• Prehospital Emergency Care
• Fluid Therapy

Deprem Afetinden Sonra Görülen Crush Sendromu ve Rabdomiyoliz Oldularında Acil Vaka Yönetimi

Abstract

Depremler; geniş çaplı yıkıma, çoklu travmalara ve yüksek mortaliteye neden olan, enkaz altında kalan bireylerde ezilme (crush) sendromu ve rabdomiyoliz gelişme riski yüksek olan katastrofik olaylardır. Bu çalışma, deprem sonrası hastane öncesi evrede ezilme sendromu ve rabdomiyoliz vakalarının acil yönetimini incelemektedir. Bu kapsamda; PubMed, Scopus, Web of Science ve Google Scholar veri tabanlarında 1 Ocak 2018 ile 10 Aralık 2025 tarihleri arasında İngilizce ve Türkçe dillerinde yayımlanan çalışmalar taranmıştır. Başlangıçta belirlenen 3439 yayından, yıl bazlı kısıtlamalar sonrası 1229’una ulaşılmış; kriterleri karşılayan 25 çalışma tam metin olarak değerlendirilmiştir. Bulgular; erken sıvı resüsitasyonu, elektrolit dengesi takibi, hiperkalemi yönetimi ve kontrollü reperfüzyonun mortaliteyi azaltmada hayati önem taşıdığını göstermektedir. Enkaz altındaki bireylere kurtarma (ekstrikasyon) öncesinde müdahale edilmesi, akut böbrek hasarı ve ölümcül aritmi olasılığını anlamlı düzeyde düşürmektedir. İnceleme; saha yönetiminde zamanın kritik olduğunu, doğru triyajın önemini ve gerektiğinde saha amputasyonu gibi hayat kurtarıcı kararların ertelenmemesi gerektiğini ortaya koymaktadır. Sonuç olarak, deprem sonrası ezilme sendromu ve rabdomiyolizin başarılı yönetimi; ileri tedavi kapasitesinden ziyade erken tanıma, sahaya uyarlanmış protokoller, personel eğitimi, ekip koordinasyonu ve zamanında karar verme sürecine bağlıdır. Hastane öncesi acil ekiplerin hazırlıklı olması ve standart müdahale algoritmalarının uygulanması, afet ortamlarında mortalitenin azaltılmasında temel belirleyicilerdir.

Keywords

• Deprem
• Crush Sendromu
• Rabdomiyoliz
• Hastane Öncesi Acil Bakım
• Sıvı Tedavisi

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