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Six P’s of Compartment Syndrome

200245912-001Sledding alone causes more than 700,000 injuries per year, and snowboarding tops the list for one-quarter of all sports-related ER visits — half of which involve broken bones, often the wrist, according to the Centers for Disease Control and Prevention (CDC).

Regardless of safety precautions, winter sports-related injuries will send many to the doctor’s office or emergency room this season. When treating a patient with a strained or sprained muscle or broken bone, be aware of a rare but serious complication known as compartment syndrome.

Compartment syndrome occurs when elevated pressure within a compartment of the body results in an insufficient amount of blood to supply the muscles and nerves with oxygen. This can occur in any enclosed space of the body, but most often occurs in the anterior compartment of the lower leg or the forearm. It can also occur in the hands, feet and buttocks.

If unrecognized or untreated, compartment syndrome can lead to irreversible damage and death of tissue within the compartment and sometimes even more serious conditions, including rhabdomyolysis (the rapid destruction of skeletal muscle) and kidney failure.

Check out the six p’s of compartment syndrome below for warning signs to watch for:

1. Pain. While this is expected with a muscle injury, pain described as deep and constant and poorly localized, that increases when stretching or manipulating the muscle, and is unrelieved by pain medications is not normal and could be a sign of compartment syndrome.

2. Paresthesia. The patient may experience a pins-and-needles sensation, tingling, tickling, prickling or burning.

3. Pallor. If you notice that your patient has pale, shiny skin, especially distal to the injury site, report the symptoms to a doctor immediately.

4. Paralysis. Though this is usually a late finding, paralysis or numbness in a limb can be a sign of compartment syndrome. This is most common when a patient’s leg or arm has been crushed in an accident.

5. Pulselessness. A diminished or absent pulse in an affected area can be caused by compartment syndrome, which creates a tourniquet-like effect and cuts off circulation to the limb.

6. Poikilothermia. This term, which refers to a body part that regulates its temperature with surrounding areas, is an important one. If you notice a limb that feels cooler than surrounding areas, the patient may have compartment syndrome.

Should you discover any abnormal symptoms that suggest a serious problem, report them to a doctor immediately. He or she will measure the pressure in the compartment with an IV catheter and needle. If the patient is suffering from compartment syndrome, a fasciotomy is required — slicing the skin and fascia covering the affected compartment to reduce pressure and increase blood flow.

Learn more about compartment syndrome by clicking the sources below, and share your tips for treating winter sports injuries with us!

Sources: The EMT Spot, Mayo Clinic and U.S. News

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