Emma (skieblue) wrote in little_details,

Crush Injury

Setting: Modern day, technology wise, but in a made-up location. (It’s kind of hard to explain without giving a lot of details about a series I’ve been working on for fifteen years.) The location is primarily based on the US, and possibly parts of Western Europe.
I have a scene where a character has gotten pinned under a pile of debris inside a building. Based on what I've been told on another forum, I've been told that this would most likely result in a crush injury.

The character is half buried under the debris, only his head and chest are uncovered. And the people that found him and are trying to get him out suspect that he is in shock, and they're certain there are injuries that aren't visible because of the way he's covered.

The ones who found him had the sense to get professional help to get him out of the building, as they suspected they might worsen his injuries if they tried to move him. (Which based on what little I've been able to understand from my research is a pretty accurate thought.) The worst of the damage is going to be the character's legs, although he also has some abdominal injuries. However, although the research I've done has been helpful in some areas, I still have a few questions.

1. What would the rescue workers need to do in order to stabilize the character enough to transport him to a hospital? I've read about the need to administer IV fluids as soon as possible, but is there anything else they would need to do. I know that he has a compound fracture in one of his legs, but I’m not sure if any other injuries are easily apparent. He has multiple fractures in both legs, as well as internal bleeding from the abdominal injuries. (And since I’m writing this scene from the point of view of a member of the character’s family, I kind of need to know how someone with no medical training would perceive the injured character’s condition. Would any injuries besides the compound fracture be noticeable to someone with no medical training?)

2. Based on the location of the injury, what kind of treatment would the character being given once he was at the hospital? I know he would need surgery, probably multiple surgeries in fact, but I am not sure in what order various things would be treated, and what treatment he would receive in addition to the surgeries. When I asked questions about this elsewhere, I was told that the setting of any broken bones would be delayed until the swelling had gone down, and because of compartment syndrome? What would be done in the meantime, to treat the injury to his legs?

3. How long would the character most likely be kept in the hospital? And once he is released from the hospital, what kind of recovery timeline is he going to have. My research has led to believe that he will be in the hospital for at least several weeks, as one page I read mentioned people being kept immobilized for up to six weeks after an injury like the one he received. And then, I'm assuming he will be in a wheelchair for a while, if not permanently, since both of his legs were seriously injured. Once the character is ready to begin rehabilitation, how will that work, since both of his legs were injured, and based on what I’ve read in the research I’ve done, would have been kept completely immobilized for at least a month and a half?

4. What is the best level of recovery this character is likely to have. I'm assuming it is almost impossible for him to have a 100% recovery. But, what I'm basically asking here, is what are the chances that he will ever be able to walk again, even? I’m leaning towards wanting him to end up with some kind of permanent damage from this, but I would like to avoid something like having his legs need to be amputated, or something. (Although, I do plan to have that be something that might be an ongoing risk for a while.)

Searched for: crush injury
Compartment syndrome
Crush injury to lower extremity
Crush injury abdomen
I wasn’t sure what to search for to look for information about rehabilitation, because whenever I’ve tried to search for that, all I ever find are ads for physical therapists.
I also asked about this on "Fanfic Med" and got some information out of the book Body Trauma: A writer's guide to wounds and injures.

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