Compartment syndrome Raised pressure in a closed osseo/fascial compartment Increasing pressure in a closed compartment compromises circulation Absolute pressure greater than 30mmHg (other numbers suggested but most accepted). Better still Pressure within 30mmHg of Diastolic pressure (Viz perfusion). Pressure monitoring Multiple methods Needle manometer (bubble-free column of saline), blockage, false readings Wick and slit catheters (bubble-free column of saline), suggested improved accuracy Solid-state transducer intracompartment catheter, level of external transducer Transducer- tipped probe if correctly positioned probably best pressure monitor All potential for false readings if not correctly positioned. Variable pressure readings in same compartment depending on site, suggest measure within 5 cm of fracture, but not directly in fracture site. Treatment Emergency any delay may increase tissue injury. Delay of 12 hours catastrophic. Within 6 hours potential for full recovery. Split dressings to skin/ Elevate limb (NOT too high as decrease perfusion pressure, at level or just above heart) Improve blood pressure, Oxygen Definitive treatment Fasciotomy
Posted on: Mon, 03 Nov 2014 12:25:45 +0000
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