Compartment Syndrome

Compartment Syndrome - Acute Compartment Syndrome Grand Rounds Paris Lovett MD November 2003 Compartment Syndrome Bugbears of Emergency Medicine

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Acute Compartment Syndrome Grand Rounds Paris Lovett, MD November 2003
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Compartment Syndrome Bugbears of Emergency Medicine What is it? Causes When to test Making the Diagnosis Management
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Bugbear Diagnoses Failure to diagnose is threatening to life, limb and wallet Clinical findings suggesting need to test are extremely common Clinical findings excluding disease are not reliable Actual disease may be uncommon Onerous, expensive, or risky test Ability of test to rule out disease may be limited Large number of negative studies Large number of false positive tests
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Bugbear diagnoses PE DVT TAD (Ansari-Ritter Disease) Traumatic Aortic Rupture Ovarian Torsion Testicular Torsion Ischemic Bowel Subarachnoid Hemorrhage Cavernous Sinus Thrombosis Intussusception Compartment Syndrome
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What is compartment syndrome?
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What is compartment syndrome? Limb Compartment Syndrome Acute Chronic Abdominal Compartment Syndrome
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Acute Limb Compartment Syndrome Raised Pressure within a closed fascial space Reduction in capillary perfusion below level needed for tissue viability Describes local manifestations and complications Don’t confuse with crush injury (systemic: acidosis, hyperkalemia, myoglobinemia, shock, ARF)
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(Chronic Compartment Syndrome) Athletes with hypertrophied leg muscles Hyperemic muscles become painful during exercise Pain relieved by rest Compartment pressures elevated even at rest Treated with fasciotomy
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(Abdominal Compartment Syndrome) An ICU diagnosis, rarely an ED diagnosis Round, tense abdomen Trauma, post-op Decreased Cardiac Output Increased Peak Inspiratory Pressure and decreased ventilation Oliguria and Renal Failure from venous and renal compression Treated with laparotomy
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Limb Compartment Syndrome: Causes Orthopedic Fractures: open or closed Management of fractures Vascular/Iatrogenic Vascular puncture: esp. anticoagulated Intra-arterial drug administration Extravasation Others Soft-tissue injury Crush Burns Hypotension: worsens all causes
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Orthopedic Causes Tibial Fx. Incidence ranges 1.5 to 29%. Depends upon
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This note was uploaded on 01/11/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Compartment Syndrome - Acute Compartment Syndrome Grand Rounds Paris Lovett MD November 2003 Compartment Syndrome Bugbears of Emergency Medicine

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