Upper Extremity Compartment Syndrome Algorithm
Upper Extremity Compartment Syndrome Algorithm: Suspected Compartment Syndrome → Clinical Assessment: 6 P's → Clinical Diagnosis Clear? → Emergent Fasci...
Interactive Decision Tree
Algorithm Steps
- ▶Start
Suspected Compartment Syndrome
Crush injury, fracture, reperfusion, snake bite
- ●Action
Clinical Assessment: 6 P's
Pain out of proportion, Pain with passive stretch
- Pressure (tense compartments)
- Paresthesias
- Paralysis (late)
- Pulselessness (very late)
- ◆Decision
Clinical Diagnosis Clear?
- ■End
Emergent Fasciotomy
Do not delay for pressure measurement if clinically obvious
- ●Action
Measure Compartment Pressure
Stryker device or arterial line setup
- ◆Decision
Delta Pressure (DBP - CP)
- <30 mmHg = Positive
- >30 mmHg = Negative
- ■End
Fasciotomy Indicated
Forearm: volar + dorsal incisions; Hand: thenar, hypothenar, interosseous
- ●Action
Serial Monitoring
Repeat exam Q1-2h, repeat pressure if concern
Guideline Source
AAOS Clinical Practice Guideline: Acute Compartment Syndrome
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Clinical diagnosis may be unreliable in obtunded patients
- Pressure measurement thresholds debated
- Time-sensitive - delays cause permanent damage
Applicable Regions
UK: BOAST guidelines similar
US: AAOS guidelines, delta pressure <30 mmHg threshold
Next steps
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Related Resources
Frequently Asked Questions
What is the Upper Extremity Compartment Syndrome Algorithm?
The Upper Extremity Compartment Syndrome Algorithm is a diagnostic clinical algorithm for Plastic Surgery. It provides a structured decision tree to guide clinical decision-making, based on AAOS Clinical Practice Guideline: Acute Compartment Syndrome.
What guideline is the Upper Extremity Compartment Syndrome Algorithm based on?
This algorithm is based on AAOS Clinical Practice Guideline: Acute Compartment Syndrome (DOI: 10.5435/JAAOS-D-18-00031).
What are the limitations of the Upper Extremity Compartment Syndrome Algorithm?
Known limitations include: Clinical diagnosis may be unreliable in obtunded patients; Pressure measurement thresholds debated; Time-sensitive - delays cause permanent damage. Individual patient factors may require deviation from these recommendations.
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