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Tissue Integrity: Compartment Syndrome - Coggle Diagram
Tissue Integrity: Compartment Syndrome
Risks
Casts/dressing that are applied too tight
circumferential burns
Fractures
Trauma
internal bleeding
S&S
paresthesia
diminished reflexes
New sharp pain that doesn't fit the injury
weakness in effected area
pallor
board like on palpation of effect area
Complications
AKI
rhabdomyolysis
tissue loss/necrosis
Amputation
nerve damage
infections
Treatment
Removal of constricting factors such as casts bandages clothing ect.
limb elevation to the level of the heart
If other measures fail a fasciectomy is performed to induce drainage of the compartment, due to high infection risk antibiotics are usually proscribed
Diagnostic
intercompartmental pressures are measured with specialized devices
Labs: CPK, urine myoglobin, Renal function tests to assess for rhabdomyolysis and risk for AKI
Most common cause is fractures, but regardless of precipitating event pressure begins to build in a compartment of the body. This is often caused from swelling from internal bleeding, inflammation, and edema. The fascia in body compartments of the limbs does not stretch and pressure builds as a result. As pressure builds blood flow becomes compromised as capillaries collapse. This causes tissues in the compartment to become ischemic and w/o intervention they die and lyse. This then compounds the problem as cellular components increase osmatic pull attracting more fluid to the area further raising pressure. Additionally as muscle cells become injured they release histamine like substances that increase vascular permeability further increasing pressure in the compartments. If intervention does not occur AKI can also result as the myoglobin from lysed myocytes is released and damage the kidney (rhabdomyolysis). All told serious tissue injury and death result and without prompt intervention amputation could be required.