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Compartment Syndrome, Emergency Medicine

Chester D. Shermer Reviewed 06/2017
 


Basics

Description

  • Elevated tissue pressure in closed spaces that compromises blood flow through capillaries

  • Normal tissue pressure is <10 mm Hg.

  • Capillary blood flow in a compartment is compromised a...

Diagnosis

  • Keep the extremity at the level of the heart to promote arterial flow but not diminish venous return.

  • Do not use ice if compartment syndrome is suspected—it may compromise microcirculation.

Signs and Symptoms

Treatment

Initial Stabilization/Therapy

  • Acutely injured extremities that are casted should have the cast univalved and spread and underlying cast padding should be cut.

  • Keep the extremity at the level o...

Follow-Up

Disposition

Admission Criteria

  • Emergent orthopedic or surgical consultation for compartment pressures >30 mm Hg

  • For compartment pressures >20 mm Hg but <30 mm Hg, surgical consultation...

Pearls and Pitfalls

  • Must measure compartment pressures or arrange transfer to higher level of care if capability is lacking.

  • Care must be taken when measuring compartment pressures to avoid injury to t...

Additional Reading

  • Farr  D, Selesnick  H. Chronic exertional compartment syndrome in a collegiate soccer player: A case report and literature review. Am J Orthop.  2008;37(7):374–377.

  • Mabee  JR. C...

Codes

ICD9

  • 958.90 Compartment syndrome, unspecified

  • 958.91 Traumatic compartment syndrome of upper extremity

  • 958.92 Traumatic compartment syndrome of lower extremity

  • 958.99 Traumatic compartment syndrome ...

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