Difference between revisions of "Compartment pressure measurement"

(See Also)
(Procedure)
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# Insert, inject 2-3 drops of saline, and await measurement
 
# Insert, inject 2-3 drops of saline, and await measurement
 
[[File:Compartment pressure striker steps.jpg|Steps to measure compartment pressure using a striker needle]]
 
[[File:Compartment pressure striker steps.jpg|Steps to measure compartment pressure using a striker needle]]
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===Technique===
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*should be performed within 5cm of fracture site
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*anterior compartment
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**entry point: 1 cm lateral to anterior border of tibia
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**needle should be perpendicular to skin
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*deep posterior compartment
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**entry point: just posterior to the medial border of tibia
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**advance needle perpendicular to skin towards fibula
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*lateral compartment
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**entry point: just anterior to the posterior border of fibula
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*superficial posterior
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**entry point: middle of calf
  
 
==Pressure Interpretation==
 
==Pressure Interpretation==

Revision as of 06:09, 30 December 2014

Indications

Compartment Syndrome Indications

Contraindications

  • Avoid areas of cellulitis.
  • No absolute contraindications

Equipment Needed

Procedure

  1. Contents of the pressure measurement kit
  2. Remove contents from wrapping
  3. Attach chamber to the pre-filled saline syringe
  4. Place the aforementioned into the monitor/unit
  5. Place needle onto chamber
  6. Eject excess air, if present, from syringe
  7. Zero the assembled unit at the angle you will be entering compartment
    1. Determine the appropriate site of injection to measure the desired compartment pressure
  8. Clean the area with alcohol prep or chlorhexidine.
  9. Insert, inject 2-3 drops of saline, and await measurement

Steps to measure compartment pressure using a striker needle

Technique

  • should be performed within 5cm of fracture site
  • anterior compartment
    • entry point: 1 cm lateral to anterior border of tibia
    • needle should be perpendicular to skin
  • deep posterior compartment
    • entry point: just posterior to the medial border of tibia
    • advance needle perpendicular to skin towards fibula
  • lateral compartment
    • entry point: just anterior to the posterior border of fibula
  • superficial posterior
    • entry point: middle of calf

Pressure Interpretation

Interpretation of Compartment Pressure

  • Normal is <10 mm Hg
  • Pressures <20 mmHg can be tolerated w/o significant damage
  • Exact level of pressure elevation that causes cell death is unclear. It was previously thought pressure >30 mmHg was toxic although the "delta pressure" may be better predictor than absolute pressure

ΔPressure = [Diastolic Pressure] – [Compartment Pressure][1]

  • ΔPressure < 30 mm Hg is suggestive of compartment syndrome

Complications

See Also

External Links

Sources

  1. Elliott, KGB. Diagnosing acute compartment syndrome. J Bone Joint Surg Br. 2003 Jul;85(5):625-32. PDF