Clinical meaning
Compartment syndrome is a limb-threatening emergency that occurs when pressure within a closed fascial compartment rises to a level that compromises tissue perfusion. Muscles and nerves within the compartment are encased in rigid fascia that cannot expand. When internal pressure increases (from bleeding, edema, or external compression), capillary perfusion ceases, leading to ischemia, necrosis, and permanent neurovascular damage if not relieved within 6 hours. The nurse must recognize early warning signs, perform frequent neurovascular assessments, and report changes immediately.
Exam relevance
Risk factors: - Long bone fractures (tibial shaft most common) - Crush injuries and severe trauma - Tight casts, splints, or dressings - Burns with circumferential eschar - Surgical positioning (prolonged lithotomy) - Massive IV infiltration - Snake bites - Reperfusion injury after prolonged ischemia
Diagnostics: - Perform neurovascular checks every 1-2 hours as ordered: pulses, sensation, movement, capillary refill, color, temperature - Assess pain intensity and character, especially pain disproportionate to injury - Report pain unrelieved by prescribed analgesics - Monitor for paresthesia (tingling, numbness, burning) - Report any changes in skin color or temperature of the affected extremity