Compartment Syndrome

Question 1

Compartment Syndrome

Answer 1

Increased interstitial pressure within a closed fascial compartment; may result from hemorrhage, edema, sustained external pressure on a limb or constrictive casts, dressings, etc., and should be suspected in any unconscious patient with a swollen limb

Question 2

Compartment Syndrome Sign/Symptoms

Answer 2

** Severe ischemic pain
** Paresthesias
Tensely swollen
Skin perfusion, arterial pulses normal
Passive stretch of muscle is painful
Progressive loss of sensory/motor function
Repeated examinations are required to check for developing compartment syndrome

Question 3

Compartment Syndrome Diagnostics

Answer 3

Stryker Tonometer

Normal compartment presure 0-8

Intra-compartment pressure >30mmHg: indicates compartment syndrome and a need for fasciotomy

Intra-compartment pressure increases within 10-30 of the patients diastolic pressure: indicates inadequate perfusion and relative ischemia of the involved extremities

The perfusion pressure of the compartment (Delta pressure): Difference between the DBP and ICP; Delta pressure = DBP-ICP. <= 30 indicative of the need for fasciotomy

Question 4

Compartment Syndrome Management

Answer 4

Release constricting appliances

Fasciotomy: effective only if performed within a few hours