Diagnosing Compartment Syndrome 

If the diagnosis is in question, it is imperative to obtain clinical compartment pressures. Prompt emergency department diagnosis by measuring compartment pressures, using a  STIC pressure monitor, is essential to minimizing patient morbidity and disability in this life-threatening condition.

Abstract

Compartment syndrome can develop in numerous compartments throughout the body, although it is commonly found in compartments within the arms and legs. Generally, fractures are the cause of acute compartment syndrome in 75% of cases. Other causes often include IV drug use, IV infiltration, burns, hemophilia, minor trauma, and snake bites.

Brief Case Description

A 29-year-old African American male presented to the emergency department with a chief complaint of left arm pain. The patient stated that he was using a power drill bit several hours before his arrival to the emergency room when the drill accidentally slipped and drilled into his left forearm. The patient reported that he had an increasing amount of pain that was migrating into his hands and fingers to the point where he is unable to move his fingers without excruciating pain.

Intervention and Outcome Summary

Acute compartment syndrome is a potentially devastating diagnosis with a tendency to damage nerves, muscles, and vasculature.  A delta pressure less than 20-30mmHg often requires a fasciotomy. Fasciotomies are the recommended, most common, treatment option for treating acute compartment syndrome.

Additional Resources
This CME will demonstrate how to check forearm compartment pressures with the  STIC  pressure monitor: Measuring Compartment Pressure (EM:RAP)  

Original Publication:

Emergency Physicians Monthly

Authors:

M. Seleno, MD, B. Drake, MD

Posted by Clinical Publication Group in Patient Stories