22d • Paramedic Talk
Medical Emergencies that tests love to use
Compartment Syndrome vs Crush Injury
Compartment Syndrome
What it is:
Increased pressure within a closed muscle compartment → decreased perfusion → tissue ischemia
Classic Signs (6 P’s – MEMORIZE)
- Pain (out of proportion, early sign)
- Pallor
- Paresthesia
- Paralysis (late)
- Pulselessness (late)
- Poikilothermia (cool limb)
Key Concept:
This is a localized limb emergency
EMS Management
- Remove constrictive items (splints, bandages)
- Keep limb at heart level (not elevated high)
- Rapid transport
NREMT Pearl: Severe pain out of proportion = compartment syndrome
Crush Injury
What it is:
Prolonged compression of muscle → release of toxins when pressure is removed
Life Threat:
- Hyperkalemia → lethal dysrhythmias
Presentation
- History of prolonged entrapment
- Weakness
- Dysrhythmias after release
EMS Management (CRITICAL)
- IV fluids BEFORE extrication
- Cardiac monitoring
- Treat hyperkalemia per protocol
NREMT Pearl: Crush injury kills through hyperkalemia, not just trauma
Esophageal Emergencies
Boerhaave Syndrome
What it is:
Full-thickness rupture of the esophagus from forceful vomiting
Presentation (HIGH-YIELD)
- Severe chest pain after vomiting
- Subcutaneous emphysema (air under skin)
- Rapid deterioration
Life Threat:
- Mediastinitis → sepsis → death
EMS Management
- Oxygen
- Treat for shock
- Rapid transport
NREMT Pearl: Vomiting + chest pain + crepitus = Boerhaave syndrome
Mallory-Weiss Tear
What it is:
Partial tear of the esophageal lining from vomiting
Presentation
- Vomiting followed by bright red blood
- Usually less severe than Boerhaave
Key Difference:
- NOT full rupture
- Less likely to cause shock
NREMT Pearl: Vomiting + bleeding but stable = Mallory-Weiss
Esophageal Varices
What it is:
Dilated veins in the esophagus (usually from liver disease/cirrhosis)
Life Threat:
- Massive upper GI hemorrhage
Presentation (MEMORIZE)
- Large amounts of bright red hematemesis
- Signs of shock
- History of liver disease/alcohol use
EMS Management
- Airway management (high aspiration risk)
- Oxygen
- IV fluids
- Rapid transport
NREMT Pearl: Alcohol history + massive bleeding = varices
Summary
Limb Emergencies
- Compartment syndrome → localized pressure, pain out of proportion
- Crush injury → systemic problem, hyperkalemia risk
Esophageal Emergencies
- Boerhaave → rupture, chest pain, critical
- Mallory-Weiss → tear, bleeding but less severe
- Varices → massive bleeding, liver disease
NREMT Test Strategy
- Identify local vs systemic problem Local limb → compartment syndrome Systemic electrolyte → crush injury
- Look at vomiting-related complications Pain + crepitus → Boerhaave Blood but stable → Mallory-Weiss Massive bleeding + liver history → varices
- Prioritize: Fluids for shock Airway in bleeding patients Cardiac monitoring in crush injury
Final Bottom Line
- Pain out of proportion = compartment syndrome
- Crush injury = hyperkalemia killer
- Boerhaave = rupture (very bad)
- Mallory-Weiss = tear (less severe)
- Varices = massive bleed (airway first)
6:36
3
0 comments
Medical Emergencies that tests love to use
skool.com/rescueacademy
Calling ALL future EMTs & Paramedics. Let's PASS the National Registry on the FIRST attempt.
Leaderboard (30-day)
1
+9
2
+6
3
+6
4
+4
5
+4
Powered by