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Objective |
Explain the pathophysiology of compartment syndrome.
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Compartment Syndrome: Pathophysiology
#88,89,90,91
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The anatomical areas and other injuries usually involved in compartment syndrome include:
bone fractures with extravasation of blood or edema within a closed compartment
high velocity penetrating injury to muscles in closed compartment with extensive tissue disruption
can also occur in subacute fashion due to prolonged immobilization on hard surface
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Compartment syndrome typically occurs in major muscle groups enclosed by inelastic, fibrous sheaths.
Principal areas for compartment syndrome are upper extremities, including thenar and hypothenar eminences of hand, and lower extremities, including the foot.
Untreated compartment syndrome will produce the same effects as a crush injury.
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Objective |
Describe the clinical presentation common with compartment syndrome.
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Compartment Syndrome: Clinical Presentation
#92 & 93
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The clinical presentation of compartment syndrome includes the “5 P’s”.
Pain to muscle group affected, especially with passive stretch
Pallor due to decreased circulation
Paresthesia initially due to metabolically induced neuropraxia
Paralysis initially due to metabolically induced neuropraxia
Pressure—tense muscle compartment (compare to other side)
> 30 mm Hg for 6 hours resulting in tissue necrosis
Progression of symptoms is sometimes added as the “6th P”. Compartment syndrome progresses over several hours, so a negative initial evaluation does not guarantee that compartment syndrome will not develop later.
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Objective |
Explain the treatment (prehospital and initial hospital) for compartment syndrome.
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Prehospital Treatment
#94
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Primary survey and initial stabilization (A, B, Cs)
Suspect compartment syndrome due to mechanisms of injury, examination, and patient complaints
Treat other injuries
Immobilize affected part; do not use constricting bandages or MAST trousers
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