Management of Orbital Compartment Syndrome SOP

Question 1

Outline the contents of the orbital compartment syndrome SOP

Answer 1

Applies to all clinical staff

Covers:
Patient assessment
Indications
Preparation
Procedure

Question 2

Outline the assessment of a patient with suspected orbital compartment syndrome

Answer 2

• Examine the eyes - gross assessment of VA, eye movements, pupils
• Shine a light through the lid to ascertain consensual response if eye closed
• High index of suspicion if anticoagulated

Question 3

What are the indications for lateral canthotomy?

Answer 3

Clinical suspicion of ocular compartment syndrome ie. abnormal vision/pupillary response
(Too far to receiving hospital)

Question 4

What should take place prior to performing lateral canthotomy?

Answer 4

Top cover discussion

Question 5

Describe the steps in preparation for a lateral canthotomy

Answer 5

(PHEA)
Confirm site with team member
Clean with saline soaked gauze
Local if awake patient
Prepare surgical kit (red bag internal compartment)

Question 6

Describe the steps in performing a lateral canthotomy

Answer 6

1. Spencer wells onto lateral orbital wall for 30 seconds
2. Cut lateral canthus with tenotomy scissors
3. Cut inferior canthal ligament
4. Cut superior canthal ligament