A nurse is assessing for compartment syndrome, a critical condition that requires prompt recognition and intervention. This guide provides a comprehensive overview of compartment syndrome, its assessment, differential diagnosis, management, and nursing care, empowering nurses with the knowledge and skills to effectively manage this condition.

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Definition of Compartment Syndrome: A Nurse Is Assessing For Compartment Syndrome

Compartment syndrome is a condition in which increased pressure within a closed fascial compartment compromises the circulation and function of the tissues within that compartment.

The fascial compartments of the extremities are formed by the investing fascia, which surrounds the muscles, nerves, and blood vessels of the limb. When the pressure within a compartment exceeds the capillary perfusion pressure, blood flow to the tissues within the compartment is compromised.

This can lead to tissue ischemia, necrosis, and eventually loss of function.

Pathophysiology of Compartment Syndrome

The pathophysiology of compartment syndrome is complex and not fully understood. However, it is believed that the following factors play a role:

• Increased tissue volume: This can occur due to trauma, inflammation, or edema.
• Decreased compartment size: This can occur due to external compression or internal swelling.
• Impaired venous outflow: This can occur due to thrombosis, compression, or increased intra-abdominal pressure.

When these factors combine, the pressure within the compartment can increase to the point where it exceeds the capillary perfusion pressure. This leads to tissue ischemia and eventually necrosis.

Risk Factors for Compartment Syndrome, A nurse is assessing for compartment syndrome

The following factors increase the risk of developing compartment syndrome:

• Trauma: This is the most common cause of compartment syndrome. Trauma can cause increased tissue volume, decreased compartment size, and impaired venous outflow.
• Surgery: Surgery can also lead to compartment syndrome, especially if the surgery involves extensive dissection or prolonged tourniquet use.
• Burns: Burns can cause increased tissue volume and decreased compartment size.
• Snake bites: Snake bites can cause compartment syndrome due to the venom’s effects on the blood vessels.
• Prolonged immobilization: Prolonged immobilization can lead to decreased venous outflow and increased tissue volume.

Assessment for Compartment Syndrome

Clinical Presentation of Compartment Syndrome

The clinical presentation of compartment syndrome can vary depending on the severity of the condition. However, the following symptoms are common:

• Pain: The pain is typically severe and out of proportion to the inciting injury.
• Swelling: The swelling is often tense and non-pitting.
• Numbness and tingling: This is due to the compression of the nerves within the compartment.
• Weakness: This is due to the ischemia of the muscles within the compartment.

Physical Exam for Compartment Syndrome

The physical exam is an important part of the assessment for compartment syndrome. The following steps should be performed:

1. Inspect the affected limb for swelling, bruising, and discoloration.
2. Palpate the affected limb for tenderness and firmness.
3. Test for sensation in the affected limb.
4. Test for motor function in the affected limb.

Pressure Monitoring Devices for Compartment Syndrome

Pressure monitoring devices can be used to confirm the diagnosis of compartment syndrome. These devices measure the pressure within the compartment and can help to determine if the pressure is high enough to compromise blood flow.

There are two types of pressure monitoring devices: wick catheters and slit catheters. Wick catheters are inserted into the compartment through a small incision. Slit catheters are placed under the fascia of the compartment.

FAQ Compilation

What are the early signs and symptoms of compartment syndrome?

Pain, swelling, tightness, numbness, and weakness in the affected area.

How is compartment syndrome diagnosed?

Physical exam, pressure monitoring, and imaging studies.

What is the treatment for compartment syndrome?

Emergency surgery to release the pressure in the affected compartment.