Which statement correctly describes initial fluid resuscitation for crush syndrome?

Which statement correctly describes initial fluid resuscitation for crush syndrome?

• A. A bolus of crystalloid fluid
• B. Oral fluids as needed
• C. Vasopressors are first-line
• D. No fluids are given

Answer: (A)

In crush syndrome, restoring circulating volume quickly is essential to protect the kidneys and improve tissue perfusion. The best approach is an IV bolus of isotonic crystalloid (such as normal saline) to rapidly expand intravascular volume and promote renal clearance of myoglobin. This initial fluid resuscitation helps achieve adequate urine output (commonly aimed at about 0.5 mL/kg/hr) and reduces the risk of rhabdomyolysis-related kidney injury. Oral fluids aren’t reliable or feasible in the acute setting, and vasopressors aren’t first-line because they don’t address the need to restore volume and perfusion. Withholding fluids would worsen hypoperfusion and kidney injury.

In crush syndrome, restoring circulating volume quickly is essential to protect the kidneys and improve tissue perfusion. The best approach is an IV bolus of isotonic crystalloid (such as normal saline) to rapidly expand intravascular volume and promote renal clearance of myoglobin. This initial fluid resuscitation helps achieve adequate urine output (commonly aimed at about 0.5 mL/kg/hr) and reduces the risk of rhabdomyolysis-related kidney injury. Oral fluids aren’t reliable or feasible in the acute setting, and vasopressors aren’t first-line because they don’t address the need to restore volume and perfusion. Withholding fluids would worsen hypoperfusion and kidney injury.