As crews search for survivors, after a two-mile wide tornado touched down in Moore, Okla., the rush is on to find people and save lives, while hospitals are flooded with survivors in need of urgent care. But there seems to be a condition that gets very little attention outside of first responder circles. Called crush syndrome, the deadly condition can kill a perfectly healthy individual, who is breathing normally, has no blood loss, and is coherent, just because part of an extremity, such as a leg or an arm, is released from being crushed under heavy-weighted building material.

When a person has an appendage crushed and caught under a heavy load, the muscle tissue begins to break down and absorb sodium, water, and calcium. If, after a few hours, the heavy load were to be suddenly removed before the patient can be prepared properly, the muscles breaking down can release toxins into the blood stream. These breakdown byproducts include potassium, myoglobin, phosphate, thromboplastin, creatine, and creatine kinase. The resulting flood of toxins can immediately shut down kidneys and result in the death of around half of those with crush syndrome.

In the United States, the Centers for Disease Control and Prevention (CDC) recommends that intravenous fluids be given to crush victims if they have been exposed to limb crushing for longer than four hours, even though it warns that crush syndrome can occur in situations where people are incapacitated for less than an hour. If IV fluid is not available, the CDC encourages a tourniquet to be used on the affected limb until IV hydration can be administered.

Current treatment guidelines for non-professional first responders in the UK include suggestions to not release the crush injury from its crush position, to not release any tourniquet in place, and flood the patient with fluids while slowly releasing the pressure off of the crushed limb. Australian first responders are told to immediately release any crushing pressure and monitor the patient's vitals.

If the patient's injury is too severe and the limb is crushed beyond repair, first responders may pursue a more severe course of action to prevent crush syndrome before any heavy pinning material can be removed. Medical technicians or doctors on scene may amputate the affected limb. Although traumatic, this can prevent crush syndrome and give the patient a better chance at life.

Once patients are taken to medical facilities after they have been freed, doctors monitor patients for hypotension, renal failure, acidosis, hyperkalemia, and hypokalemia, all of which can send the patient into shock and death. Patients are to be given antibiotics and kept well-hydrated to stave off any of these secondary syndromes. With proper management, victims of building collapses can be freed and regain good health with recovery.