Crush injuries to the hand and forearm from mechanical devices and heavy equipment are a frequently seen injury in heavily industrialized areas. These injuries are particularly difficult due to their unpredictability, individualized nature and often devastating results. To optimize the outcome for these patients, it is essential to educate the nursing staff on emergent as well as ongoing care, form a systemized plan of care, and recruit patient and family support. A multiskilled group effort will be required to allow the patient with crushed tissue to realize optimal potential and return to a functional position in society.