Disaster nephrology: crush injury and beyond.
Kidney Int
; 85(5): 1049-57, 2014 May.
Article
in En
| MEDLINE
| ID: mdl-24107850
ABSTRACT
Disasters result in a substantial number of renal challenges, either by the creation of crush injury in victims trapped in collapsed buildings or by the destruction of existing dialysis facilities, leaving chronic dialysis patients without access to their dialysis units, medications, or medical care. Over the past two decades, lessons have been learned from the response to a number of major natural disasters that have impacted significantly on crush-related acute kidney injury and chronic dialysis patients. In this paper we review the pathophysiology and treatment of the crush syndrome, as summarized in recent clinical recommendations for the management of crush syndrome. The importance of early fluid resuscitation in preventing acute kidney injury is stressed, logistic difficulties in disaster conditions are described, and the need for an implementation of a renal disaster relief preparedness program is underlined. The role of the Renal Disaster Relief Task Force in providing emergency disaster relief and the logistical support required is outlined. In addition, the importance of detailed education of chronic dialysis patients and renal unit staff in the advance planning for such disasters and the impact of displacement by disasters of chronic dialysis patients are discussed.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Renal Dialysis
/
Crush Syndrome
/
Disaster Planning
/
Renal Insufficiency, Chronic
/
Acute Kidney Injury
/
Fluid Therapy
/
Health Services Accessibility
/
Nephrology
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Humans
Language:
En
Journal:
Kidney Int
Year:
2014
Document type:
Article
Affiliation country:
Canada