On January 17, 1994, the Northridge Earthquake struck Los Angeles, California. Inside a three-story reinforced concrete parking garage, Salvador Peña was operating his street sweeper. As the quake struck, the structure collapsed on top of Peña, trapping him in the sweeper under concrete support beams. For nine hours, members of the Los Angeles City and County Fire Departments worked to free Peña, dealing with operational issues including working in an unstable structure, the possibility of aftershocks, spilled fuel from the sweeper, and the possibility of Peña’s initial injuries progressing to crush syndrome during the rescue.
As paramedics gained access to the patient, they evaluated and cared for Peña’s crush injuries and treated him for crush syndrome as the concrete beams were lifted. Throughout the operation, paramedics coordinated care with UCLA Medical Center, where Peña was ultimately flown for additional treatment. Without careful coordination among the urban search and rescue team, emergency medical services (EMS), and the destination hospital, Peña’s condition might have had a very different outcome.1
Physical entrapment can be associated with a variety of problems including soft tissue, inhalation, blast, and musculoskeletal injuries; thoracoabdominal trauma; and burns. A crush injury is defined as compression of muscle mass causing damage, compromised circulation, and swelling.2 The most commonly affected areas are the lower limbs (74 percent), the upper extremities (10 percent), and the trunk (nine percent). (2)
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