What immediate step is critical in managing crush syndrome?

Administering IV fluids is critical in managing crush syndrome because it helps to prevent acute renal failure and other complications that can arise due to the release of myoglobin and other substances into the bloodstream after the release of pressure from a crushed limb. When muscle tissue is damaged, it can release high levels of myoglobin, potassium, and other intracellular components into circulation, which can lead to renal tubular obstruction and hyperkalemia.

By providing intravenous fluids, you facilitate adequate hydration and dilution of these harmful substances, thereby promoting urinary excretion and reducing the risk of acute kidney injury. Additionally, IV fluids help maintain blood pressure and ensure adequate perfusion to vital organs that may be compromised due to shock or injury.

Other management steps, such as setting a fracture, monitoring vitals, and applying ice packs, are important in broader trauma management, but they do not address the immediate physiological needs that arise from crush syndrome in the same urgent manner as fluid resuscitation does.