Compartment syndrome Flashcards
What is the viscious circle?
Swelling -> increase pressure -> no pressure gradient for oxygen to move across in capillary -> ischaemia -> infarction -> swelling
How long does it take to become irriversiable?
Over 4 hours it can start becoming irreversiable
Drug addicts can gt acs how?
either through inserting inflammatory substances or by beoming unconcious etc and lying on one part of limb.
Why do we have to think about it in reprofusion?
Becasue the as the normal blood supply is delivered to the old semi ischaemic area there will be a lot of swelling
What is the main cause of compartment syndrome?
fracture
What else can cause compartment syndrome?
Soft tissue injuries, crush injuries, burns (circumferential eschar), drug users, lying on ones spot for too long, bowel surgery position (esp in low bp anyway, aka post lithotomy postisioning), tight bandages/casts, vascular reprofuson, haemorrhage (think anticoag/bleeding disorder), acute and chronic exertional.
What is the issue with the 5 p’s?
Most of them are super late stages and we need to be catching it way before!! So: need: Pain, Pressure and swelling are key ones. Later on will get tingling (Parasesthia), then pallor, then paralysis and pulselessness (v late stages).
Diastolic anc compartment pressure = what?
So if the difference between diastolic bp and compartment is less than 30mmHg then this is very much bad.
What makes us mre likely to develop compartment syndrome?
Hypotensive
Do we need to check in the unconcioius patient?
Unconciouls patient, low bp and swelling of a limb -> monitor compartment pressure with arterial pressure thingy.e
What do we do about it?
Look at the limbs and continually check for compartment syndrome. Have a very low index of suspicion. In which case you uncover the dressings (remember can occur through too tight of an external dressing etc, and look at the skin. If still v painful then need to elevate asap and get the surgeons to make an inscision.
