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DawnMcBride

What is the pathophysiology of compartment syndrome?

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Air goes in and out; blood goes round and round; pink is good, blue is bad.  It's all pretty much in there.

 

SK

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You break your femur and 3 units of your 5-6 units of blood can pool in your thigh - a confined set of discrete spaces where muscles are linked together by connective tissue. 

The swelling cuts off blood supply to everything.

Muscle dies, nerves die, tissue necroses.

Nothing good happens.

 

Irreversible damage can occur within an hour unless released.

 

Again, research and then ask questions. What are you specifically looking for and why?

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Compartment syndrome is a great topic clinically and from a "pimpable" standpoint.

 

The jury is out on when tissue is irreversibly lost, but better to air on the side of caution and get surgery/ortho/whomever on board sooner rather than later. I particularly enjoy the 6 Ps of compartment syndrome: pain, pallor, poikilothermia, polar, paresthesias, and pulselessness.

 

An important consideration is that if you have a cold extremity without pulses, you've already missed the diagnosis!

 

Saw a patient on my ER rotation who had a FLORID compartment syndrome with compartment pressures into the 80s but still had a pulse in the impacted extremity. Pulses are a late loss, so be very weary of this diagnosis! A must not miss in any setting. 

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Pssst - I grow weary of misuse of certain words, but am very wary of compartment syndrome ;-).

 

I'm very wary of it because of the suit I was named as a respondent in was a result of a poor outcome of a fasciotomy and thrombectomy of someone with it...because they came too late and blamed everyone around but themselves.

 

SK

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