EMG/General/TBT-EMG-013

Crush Injury Emergency Response

Emergency Preparedness › General › Crush Injury Emergency Response

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Crush injuries occur when a body part is compressed between heavy objects such as plant, materials, or structures.
Construction activities with high crush risk include lifting, plant operations, excavation, and steel erection.
Crush syndrome develops when a compressed limb is released — toxins flood the bloodstream causing organ failure.
If a casualty has been trapped for more than 15 minutes, medical advice should be sought before releasing them.
Immediate first aid for a crush injury includes controlling bleeding, monitoring for shock, and keeping the casualty warm.
Do not apply a tourniquet to a crushed limb unless there is life-threatening bleeding and no alternative.
Emergency services must be called immediately for any crush injury — these are time-critical emergencies.
The trapped casualty should not be given large volumes of fluid to drink before medical advice.
Scene safety is the first priority — ensure the crushing force is stabilised before approaching the casualty.
All site first aiders should be trained in crush injury recognition and initial management.

Crush syndrome	Releasing a crushed limb after prolonged entrapment can cause lethal toxin release — medical guidance is critical.
Time critical	Crush injuries deteriorate rapidly — early emergency service involvement significantly improves survival.
Scene safety	The crushing object may be unstable — rescuers can become additional casualties if the scene is not secured.

Don't

Call 999 immediately for any crush injury and state how long the person is trapped
Ensure the scene is safe before approaching — stabilise the crushing object if possible
Control any visible bleeding using direct pressure and wound dressings
Monitor the casualty for signs of shock including pale skin and rapid pulse
Keep the casualty warm with blankets or coats while waiting for emergency services
Seek medical advice before releasing a casualty trapped for more than 15 minutes
Reassure the casualty and keep them as calm and still as possible
Note the time the crushing started and communicate this to the paramedics
Clear a path for emergency vehicles and guide them to the casualty location
Train all site first aiders in crush injury recognition and initial management

DON'T attempt to release a casualty trapped over 15 minutes without medical advice
DON'T approach the casualty until the crushing object is confirmed stable and secure
DON'T apply a tourniquet unless there is uncontrollable life-threatening bleeding
DON'T give the trapped casualty large amounts of fluid before paramedics advise
DON'T move the casualty unnecessarily after release — wait for paramedic assessment
DON'T delay calling emergency services to attempt rescue with site equipment alone
DON'T forget to tell the operator how long the person has been trapped
DON'T allow other workers to crowd the scene — keep the area clear for responders
DON'T remove the crushing object suddenly without understanding crush syndrome risk
DON'T leave the casualty unattended — monitor their condition until help arrives

See also: Medical Emergency Response | First Aid Response and Triage

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