Man-made or massive natural disasters may be followed by ‘epidemics’ of the muscle crush syndrome. The first descriptions of the crush syndrome were in the German-language literature following the earthquake of Messina in 1909 and World War II. On the threshold of World War II, the English-language literature was still unaware of the crush syndrome. During the London Blitz in 1940, Bywaters clearly delineated the pathogenesis of the crush syndrome and established guidelines for the management of casualties. The experience from the war in southern Lebanon in 1982 showed that early volume repletion can prevent acute renal failure in casualties with the crush syndrome. Following the major earthquake at Spitak in 1988, massive international relief effort helped to rescue and salvage many casualties. International preparedness contingency plans will increase the survival of future casualties suffering from crush injury.

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