Surprisingly, new studies are showing that immobilizing spinal injuries doesn’t make any difference. I can’t find a cite for that; my husband came across it in his construction safety job, so I’ll ask him where he got that information.
I know about Duncan, I saw him on TV actually. but since he didn’t die, his story doesn’t count.
I want to know about the little girl who was still alive.
We had a local news person who had a ruptured blood artery of some type in the abdomen AT the hospital and bled out internally before they could operate. So the answer would be yes if it involves a main artery of some kind that is held shut by pressure.
Robot Chicken’s version of the story.
It’s been happening in Haiti after the earthquake. There must of been a few that died right after the ruble is lifted off them. The news has reported some are dying a day or so later. I don’t recall the medical term (CNN’s medical correspondents used), but bodies don’t respond well to compression. They can shut down even though the weight is removed.
The version that was popular, when I was in high school, went like this; Motorcyclist with one of those full visor, well padded, helmets slams into bridge abutment at high speed. First people on the scene are shocked that he is ambulatory, if confused. When first responders arrive, put him into ambulance and remove helmet, he dies instantly because nothing but the helmet was holding his head together.
There’s just enough truth in your title to not dismiss the concept entirely.
However the “immediately” is not typical, especially if you are proposing a scenario where the precipitant of the demise was directly related to release of the crushing pressure.
Crushing soft tissues does create problems with buildup of various “toxins.” Examples might be lactic acid (from the ischemia) and muscle proteins (myoglobin, e.g.) which can be harmful to the kidneys. It is also theoretically possible for potassium to build up in the crushed part. Potassium is mostly intracellular, so a perfect crush mechanism that damages cells and causes them to leach potassium, (but leaves the vasculature intact somehow)could theoretically cause a massive infusion of potassium from the crushed area to the heart, killing the patient the moment the crushing force is released and circulation is restored. (Acute renal failure from myoglobin takes much longer and wouldn’t happen with proper medical care; big release of lactic acid is not usually that big of a deal.)
I have never seen this (immediate death following a crush release), although I have seen a number of late deaths after a crush, and slow deaths during a crush. The average badly crushed body part also has crummy perfusion even post-crush which would, on average, be protective against perfusing a huge surge of potassium, so to my mind this is one of those things that’s theoretically possible but unlikely.
I can also envisage a scenario where a patient has very fragile hemodynamics based on the general trauma, and when the crush is released, the change in hemodynamics tips them over and they exit this world on the spot.
Finally (off the top of my head) I’d say it’s theoretically possible for a crush to be tamponading a lacerated artery (would pretty much have to be the femoral, I guess) and removal of the crushing force releases the tourniquet effect causing exsanguination. Shouldn’t happen with the brachial artery (a bit small for sudden death from exsanguination) and anything north of the femoral would mean the injury is intraabdominal; I think you’d check out from other causes if there were a force so great it’s tamponading a large branch off the abdominal aorta.
Yes yes yes. I googled. I tried to go for funny with tampon-aid and blood loss. Didn’t work. As you were. 
The scenario you describe is possible, and while not common, does happen.
The physiology is simular to the use of MAST pants. The crushing object and the pants obstruct blood flow in the lower half of the body, forcing blood to remain in the vital organs, brain, liver and heart. In the case of the MAST pants, the pants are left in place until bleeding can be stopped and/or drug support for the blood pressure is in place. They are usually left in place until the patient is in the OR and under anesthesia.
With a crush injury, the moment the object is removed, blood leaves the upper body causing unconsciousness followed quickly by death.
Anyone else remember this scene from Scary Movie 3?
My understanding is that the toxins released by rhabdomyelosis caused by a crush or ischemic injury can cause not only kidney damage but also a potentially fatal cardiac arrhythmia.
It was portrayed in House when they showed the origin of his limp. He suffered a blood clot to his right thigh muscle (ischemic attack). The toxins released by the dying muscle caused his urine to turn brown - indicating rhabdomyelosis and kidney damage - and a short time later, House ordered a nurse to bring an injection (calcium? Potassium?) as he predicted his own cardiac arrest.
These days, I think they keep very close tabs on EKGs of people who’ve suffered muscle damage due to a crush or ischemic injury.
You’re right, but the damage caused by rhabdomyolysis happens over hours to days. It causes multi-system failure, but with critical support, can be overcome.
She was only 3. Her father was carrying her between subway cars. I don’t know if she slipped from his grasp, the cars lurched or what have you, but she went through and ended up bisected and still breathing. She did die though, just not instantly.
I make my cardiac tamponade out of seven different kinds of meat, three types of olives and goose fat. It is to die for.
In EMT school I was taught about a type of shock-preventing “suit” that medics could use which would squeeze the lower part of the patient’s body. This made the blood circulate more above the waist, where all the important organs are. My instructor told me these “suits” are rapidly falling out of fashion and getting removed from local protocols all over the nation because the patient experiences immediate hypovolemic shock the moment the “suit” is cut off. The suits have (had? I’ve never seen one) a warning printed on them NOT to simply cut them off in the hospital setting in order to prevent that from happening, but enough people are not properly trained how to properly remove the suit that it ended up more likely to harm the patient than help them. I know these suits exist because I have pictures and instructions for how to use one in my EMT coursebook.
Because of the above, I’m not skeptical at all that someone could have a lower-body crush injury, in which they didn’t actually die until the restricting object was removed.
See post # 29. The suit you’re talking about is actually Military anti-shock trousers, or MAST pants. They come just above the waist.
Sorry. I just got so excited about being able to answer something in GQ that wasn’t really answered in the first few posts that I just kind of “skimmed” the rest.
My husband relates a similar story from his early days with the City here. A man was impaled and pinned down by the corner of a bulldozer blade in a construction accident (lower abdomen IIRC). When the machine was backed off of him, he bled out quickly and died. Before the machine was removed he was talking calmly to the other construction crew guys. It seems to me that the blade must have been keeping an artery pinched off.
No problem. You answered the question well.
There was an episode of China Beach involving MAST pants which kept the soldier alive long enough to write a goodbye letter to his loved ones. It was haunting. Man, I wish that show would come out on DVD.