Your trauma patient has her left hand caught between rollers on a conveyor belt. Extrication takes 30 minutes.  Evaluation of the injury during extrication showed delayed capillary refill distal to the injury.  Post extrication shows rapid capillary refill distal to the injury deformity mid-palm.  There are no obvious fractures, no lacerations, and minor swelling.  Knowing that crush injuries can cause many other problems, which is NOT considered a crush injury complication?

Crush injuries occur when tissue is caught between two objects causing increased pressure.  When this pressure is exerted over a long period of time, tissue is damaged resulting in lacerations, fractures and anaerobic injuries.  When blood flow is cut off, oxygen does not make it to the tissue which results in a reversion to anaerobic metabolism generating lactic and pyruvic acids.  In time, this damages more tissue causing the release of more acids and by-products of incomplete metabolism. Eventual results are more swelling and coagulation problems, loss of tissue and loss of life.