EM Quick Hits Video on Compartment Syndrome recognition and management with Arun Sayal
Compartment syndrome clinical pitfalls
- Do not rely on the presence of a fracture to suspect the possibility of compartment syndrome; 30% of compartment syndromes.are due to injuries that do not involve fractures, such as high pressure injection injuries, tight casts and dressings, soft tissue injuries, burns, extravasation of IV fluids.
- Do not dismiss the possibility of compartment syndrome in the setting of an open fracture.
- Do not dismiss the possibility of compartment syndrome when pain is the only finding; of the 6 Ps (Pain, Paresthesias, Paralysis, Pulselessness, Palor, Poikilothermia), all except pain are often not present when patients initially present to the ED.
- Pain out of proportion, especially with passive stretch of the compartment, in addition to a palpable tight/tender compartment is enough to suspect the diagnosis
- Measurement of compartment pressures using a Stryker needle are inaccurate and may be misleading in the diagnosis of compartment syndrome; measurement of compartment pressure should not be a prerequisite for consulting orthopedic surgery for a suspected compartment syndrome
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