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domingo, 8 de noviembre de 2020

Extremity Compartment Syndrome

emDocs - By Kim Dennis - November 06, 2020 
Originally posted on Trauma ICU Rounds on October 10, 2020
"What are the 5 or 6 Ps? If you answered Pain, Pain, Pain, Pain, Pain, and Pain, you can go right ahead and skip this episode. Extremity compartment syndrome is an acute surgical emergency and requires a HIGH index of suspicion in order to make the diagnosis. Therapy consists of fasciotomy. If left untreated, numerous complications and sequelae may develop including AKI and even death...
Take Home Points
  • Extremity compartment syndrome is an acute surgical emergency that required a HIGH INDEX OF SUSPICION
  • Although commonly associated with fractures (especially, tib-fib and distal forearm), up to 1/3 of patients have NO LONG BONE FRACTURE
  • Pain out of proportion or on passive stretching of a muscle group and paresthesias are the first signs of extremity compartment syndrome
  • Physical exam, specifically, feeling for the tenseness of a compartment is UNRELIABLE
  • In the leg, the ANTERIOR and DEEP POSTERIOR compartments are the most frequently missed!
  • If you suspect it, DO SOMETHING = either a compartment pressure check OR fasciotomy"