The EM Educator Series: Compartment Syndrome Pearls & Pitfalls

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case:

A 24-year-old male was hit by a car at low speeds and suffered a tibia fracture. He suffered no other injuries and has been splinted. However, his pain continues to increase, despite repeated doses of morphine.

 

Considerations:

  • When should you consider the diagnosis of compartment syndrome, and who’s at risk?
  • What are the most common anatomic locations involved in compartment syndrome?
  • What is your differential for pain out of proportion? What other conditions cause severe pain?
  • What are the problems with the 6 P’s? What about severe pain and/or paresthesias plus a risk factor for compartment syndrome?
  • How do you calculate delta pressure?
  • What is the management of compartment syndrome?
  • What are the complications if the diagnosis is missed?

 

From Dr. Katy Hanson at Hanson’s Anatomy:

 

Suggested Resources: 

  • Articles:
  • PMID:

 

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