Compartment Syndrome

Question 1

What is compartment syndrome..

Answer 1

Blood vessels and nerves run along the fascia around the muscle. The fascia does not stretch, the blood vessels and nerves become compressed

Anything that puts pressure inside or outside of the compartment that compresses the nerves, BVs

Question 2

5 Ps

Answer 2

1. Pain
2. Paresthesia
3. Paralysis
4. Pallor
5. Pulselessness

Question 3

First P

Answer 3

Pain - Deep throbbing, pressure like

Pain is made worse with passive stretch

Question 4

2nd P

Answer 4

Paresthesia - loss of sensation

Compression of the nerve

Question 5

3rd P

Answer 5

Paralysis
Nerve compressed
“limb giving out.”

Question 6

4th P

Answer 6

Pallor

Tissue actively dying

Question 7

5th P

Answer 7

Pulselessness

Last sign - usually gone limb

Question 8

Intercompartmental pressures normal

Answer 8

<10mm

Question 9

Pressure 20-30mm

Answer 9

Careful observation

Question 10

Pressure >40 mm

Answer 10

Likely surgical decompression

Question 11

Tx for compartment syndrome

Answer 11

Remove external pressure
Place at level of the heart
Remove ice - further vasoconstrict

Question 12

5 causes of Internal compartment syndrome

Answer 12

1. Bleeding - injury
2. Edema - Injury
3. Insertion of external substances (high pressure pain or grease gun)
4. Recent surgery
5. Tissue damage - crush injury

Question 13

3 Causes of External compartment syndrome

Answer 13

1. Circumferential casts, splits etc
2. Circumferential burns causing inelastic skin around the muscle compartment
3. Vascular or arterial blood loss w/ hematoma putting pressure on the compartment