Dr Beaver's tute - compartment syndrome Flashcards
what is compartment syndrome
increased pressure in a closed fascial compartment
compartment syndrome happens after
post fractures and dislocation, burns, crush
what signals compartment syndrome
pain out of proportion to the injury
pain on passive stretch of muscle
extreme tenderness to touch
soft tissue swelling
tight, wood-like muscles
delta pressure
diastolic blood pressure - intracompartmental pressure
<30mmHg strongly suggests compartment syndrome
what it a compartment
confined by bone, ligament or fascia
fascia is
connective tissue made with collagen
pathophysiology of compartment syndrome
injury, tissue swelling,
increased compartment pressure,
decreased perfusion pressure,
local hypoxia,
call membrane damage
how much pressure needed to close a capillary
25-30mmHg (not much)
after this the muscle cannot get oxygenated and will build up lactic acid and may die
if unsure what to do
decompress
volkmann’s isachaemic contracture
muscle is dead and has turned to scar tissue (super bad)
muscle contracts when it turns to scar tissue so the muscle is too short
symptoms occurring in later stages of acute compartment syndrome
signs of poor tissue perfusion eg. pallor, pulselessness
signs of nerve damage eeg. parasthaesia, paralysis
suggestive of irreversible tissue damage
supportive care for compartment syndrome
remove constrictive dressings, splints, and devices
provide systemic analgesia
place limb at the level of the heart
reduce any displaced fractures
administer supplimental oxygen
why do you avoid elevating the limb
this may worsen ischaemia by reducing blood flow
rebound compartment syndrome
6-12 hours after surgical repurfusion
due to insifficient fasciotomy incisions
