[Crush injury of the lower limbs. Use of anti-shock trousers].

A case of lower limb crush injury is reported. A 16 year old female sustained severe soft tissue, muscle, skeletal and vascular lesions during a road traffic accident. She rapidly presented with severe haemorrhagic shock due to a popliteal arterial injury. At the scene, massive vascular loading by emergency physicians using both colloids and group O negative packed red cells was not enough to improve the haemodynamic state, even though there was adequate control of the bleeding artery. The pneumatic antishock trousers were therefore used despite the severe injuries to the legs, with rapid improvement of the haemodynamic parameters. By using bilateral femoral nerve blocks, the limb fractures were reduced rapidly; this decreased ischaemic time and allowed correct placement of the garment. Although the left leg was amputated above the knee, the postoperative course was uneventful. The authors insist on the important part such early management at the scene plays in preventing acute post-traumatic renal failure.