Flashcards in Compartment Syndrome Deck (13)
Why do you still feel palpable pulses in the acute setting of a compartment syndrome?
because these vessels are extra-compartmental
at what pressure do we worry about compartment syndrome?
how do we measure compartment pressure?
multistick needle catheterization
Where should needle stick catheterization be performed when measuring compartment pressures?
1. between each of the metatarsals for each of the interosseous compartments
2. advance the needle further in the 1st IM space to measure the adductor compartment pressure
3. insert needle laterally, plantar to 5th met to obtain lateral compartment pressures
4. medially, 4cm inferior to medial malleolus over ABH to obtain medial compartment pressure
true or false: compartment syndrome is a surgical emergency. Why?
true. if not recognized promptly, can cause muscle ischemia, necrosis and irreversible damage.
when obtaining compartment pressures, should you use local anesthetic prior to inserting the catheter? why or why not?
NEVER inject LA prior to inserting the catheter bc the anesthetic fluid will increase the interstitial pressure and give a falsely elevated compartment pressure reading.
What are the S/S associated with compartment syndrome?
pain (on passive stretch )
paresthesia- change in sensation
poikilothermia- inability to control temp
what is normal compartment pressure?
how many anatomic compartments are in the lower leg?
4 (anterior, lateral, superficial posterior, deep posterior)
What additional lab tests could you order if you suspect compartment syndrome?
UA- see if myoglobin is being released and being filtered to kidneys
-check creatine kinase
what injuries is ACS most commonly associated with?
Lisfranc and metatarsals- 41%
calcaneal fx- 17%
what are some complications of ACS?
myoglobinuric renal failure