When treating a patient with a crush injury, which fluid is appropriate for resuscitation?

When treating a patient with a crush injury, which fluid is appropriate for resuscitation?

• A. Normal Saline
• B. Lactated Ringer's
• C. Plasma
• D. Dextrose solution

Answer: (A)

In crush injuries, the priority is rapid, sustained IV fluid resuscitation to protect the kidneys from myoglobin and maintain renal perfusion. An isotonic crystalloid is best for this role because it expands the intravascular volume without introducing extra electrolytes that could complicate rhabdomyolysis management. Normal saline fits this need well: it stays in the vascular space long enough to support circulation and urine production, it does not add potassium or lactate, and it’s readily available for large-volume resuscitation. Lactated Ringer’s contains potassium and lactate, which can complicate electrolyte and acid-base balance in rhabdomyolysis, so it’s not as preferred for initial resuscitation. Plasma is a blood product intended for hemorrhagic shock or coagulopathy, not routine resuscitation in crush injury. Dextrose-containing solutions provide free water after metabolism and can worsen hyperglycemia and electrolyte shifts, making them less suitable for early volume expansion.

In crush injuries, the priority is rapid, sustained IV fluid resuscitation to protect the kidneys from myoglobin and maintain renal perfusion. An isotonic crystalloid is best for this role because it expands the intravascular volume without introducing extra electrolytes that could complicate rhabdomyolysis management. Normal saline fits this need well: it stays in the vascular space long enough to support circulation and urine production, it does not add potassium or lactate, and it’s readily available for large-volume resuscitation.

Lactated Ringer’s contains potassium and lactate, which can complicate electrolyte and acid-base balance in rhabdomyolysis, so it’s not as preferred for initial resuscitation. Plasma is a blood product intended for hemorrhagic shock or coagulopathy, not routine resuscitation in crush injury. Dextrose-containing solutions provide free water after metabolism and can worsen hyperglycemia and electrolyte shifts, making them less suitable for early volume expansion.