Barriers delaying treatment in cases at risk of crush syndrome in major disasters: Kahramanmaraş earthquake experience.
Journal of nephrology · 2026-08-28 · Qualitative study
Abstract
BACKGROUND: Crush syndrome is a life-threatening condition in disasters, particularly earthquakes. Early fluid therapy is critical to reduce morbidity and mortality, yet disaster settings often hinder timely intervention. METHODS: This qualitative phenomenological study explored the experiences of 20 emergency medical service personnel involved during the acute phase of the February 6, 2023 Kahramanmaraş earthquakes. Data were collected through in-depth interviews, transcribed verbatim, and analyzed using MAXQDA 2020. RESULTS: Three primary treatment initiation points were identified: during extrication, after rescue at the scene, and inside the ambulance. Five key barriers to timely crush syndrome intervention emerged: (1) crowd density, (2) media interference, (3) inadequate search and rescue training, (4) lack of scene safety, and (5) resource shortages. These factors significantly delayed early fluid therapy for high-risk patients. CONCLUSIONS: Although emergency medical service personnel recognize the urgency of early crush syndrome treatment, operational barriers impede timely care. Integrating health-care professionals into search and rescue teams, improving -inter-agency coordination, and ensuring scene safety are essential strategies for enabling earlier intervention. These findings highlight the need for targeted disaster preparedness policies addressing crush syndrome-specific response requirements.
Tags
Crystalloids · Extrication · Fluids & blood · Implementation · Interagency collaboration · Military & tactical · Paramedics & EMTs