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Monday, September 13, 2021

Acute Compartment Syndrome

emDocs - September 13, 2021 - By Martin Yang
 Reviewed by: Courtney Cassella; Alex Koyfman; Brit Long
Take Home Points:
  • 5 Ps = PAIN, pallor, paresthesia, paralysis, pulselessness
  • Increasing pain despite analgesia should increase suspicion for ACS.
  • Passive stretch of compartment thought to be most sensitive exam finding.
  • Compartment pressures: <10 mmHg normal, >30 mmHg concerning for ACS
  • Consider use of delta pressure for monitoring in equivocal exams.
  • Special consideration with hypotensive patients, lower pressures required to overcome arterial pressures.
  • Treat associated rhabdomyolysis, hyperkalemia, and acute kidney injury.