Acute compartment syndrome is when the pressure in a muscle compartment increases, compromising circulation and function. This occurs because the compartment is surrounded by a fascial membrane that restricts further expansion. It typically occurs after trauma, crush injury, or burns. Signs include severe pain (earliest sign), pallor, paresthesia, paresis, and pulse deficit. To measure compartments, you take your measurement device and insert it into the compartment of interest.
How to set up your measurement device:
Your materials include a sterile 3cc saline syringe, chamber, and needle. The needle has a side port (hole) for measuring pressure.
Connect the syringe, chamber, and needle
Flush the chamber and needle with saline to get rid of the air; do this by holding the entire device at a 45-degree angle.
Load into the monitoring unit and press zero, you should see 00
Insert the needle into the compartment of choice and hold it for reading
There are two ways to assess for compartment syndrome. You can use the absolute or delta pressure (normal: 0-8). Suspect compartment syndrome if:
the absolute pressure is > 30 mmHg
OR
The delta pressure is < 30 mmHg
Delta pressure = diastolic pressure - compartment pressure. This means that the pressure in your compartment is so high that it is close to your diastolic blood pressure
Tip: remember the number 30
These patients require a fasciotomy so call ortho ASAP. Meanwhile, you should level their affected limb and support BP if hypotensive to help maintain perfusion.
Thanks for reading!
-Ariella
References:
https://www.emrap.org/episode/trauma1/compartment
https://www.emrap.org/episode/measuring/measuring