 What comes in nursing school explained in this video on compartment syndrome. To understand what happens in compartment syndrome we have to first understand the fascia that surrounds the different compartments of a limb. So if we look at this cross section here so there's bone if I for example cut my lower leg the cross section I look at it from that perspective I would have my tibia my fibula as the bones in there but I also have muscle tissue as well as blood vessels and nerves and all these structures are surrounded by fascia and what the fascia it surrounds these compartments and when there's compartment syndrome that means there is increased pressure to any of these structures because of edema or hemorrhage whatever the the cause might be and we look at those later and then because there is this increased pressure the fascia gets compressed so it puts pressure on the muscle on the nerves on the blood vessels as well as the bones because there's only so much space available and when it becomes compressed when it compresses the blood vessels that feed these different compartments they become ischemic because now we have decreased blood flow that leads to hypoxia whenever hypoxia occurs the body sends extra inflammatory markers there to try and help resolve this and increases the capillary permeability then we have increased fluid there and now in an already compressed space now increased fluid means increased pressure and we are back here in this vicious cycle so then again we have hemidema compression of the fascia ischemia so it kind of gets worse and worse and worse that's the pressure bill so there is no real good way out so risk factors to developing compartment syndrome are fractures any kind of fracture mostly of the long bones but think about it when a bone gets fractured there is some severe bleeding and edema that occurs and that puts pressure on these compartments so bad hematomas and contusion so not even fractures but just like a really bad crush injury let's say to the thigh or to an arm can cause some bleeding and a contusion and the bleeding causes pressure on these different compartments casts and splints if we apply those and we don't account for the swelling that might occur after the injury the splint and the cast can act as a constraining factor so the tissue can't expand as it would usually when it swells up and so then it causes compression of these compartments burn injuries certainly because of the the factor of the tissue injury also causing edema and pressure DVT usually causes edema can it can get so severe that there is now this edema causing pressure on these compartments and then heavy exercise so if you keep using your muscles over and over you pound your muscles they will get inflamed they will get swollen they will come edematous and they can lead to compartment syndrome so early signs and symptoms include pain and then maybe normal or decreased peripheral pulses because if we have pressure on these blood vessels then the blood going through well the blood flow going through will be diminished and we can it can be evident in the distal part of the body by diminished pulses if we don't catch this early the patient later will get cyanotic because there's no blood flow coming through there will be peristusia so numbness and tingling because the nerves get compressed there will be weakness or paralysis because now the muscle has impaired movement and impaired blood flow absent peripheral pulses are now not no blood flow is coming through it because the blood vessels here are so compressed that we're not perfusing the distal part of the extremity and then certainly severe pain because now we're talking about ischemia and hypoxia and we always know that that causes pain as for a treatment a fasciotomy is the only way to treat it and what that means is that the muscle the the extremity has to be cut open to relieve that pressure let that a demon at that fluid that blood come out and relieve that pressure on these compartments so the circulation and the nervous system can work again diagnostic tests are x-ray CT scans to look at the different compartments of the severity or whatever the underlying causes and then we can measure the compartment pressure there's a certain tool that the orthopedist carry with them and the surgeons and they can actually put that inside the muscle tissue and it'll give them the reading of the compartment pressure and then depending on how high that reading is they'll determine if the patient needs a fasciotomy or if we maybe can wait and see maybe with elevation ice and those things and then the other thing too for treatment fasciotomy not only but think about it if it is because of a cast or a splint we just need to remove that external factor that castle that splint so that extremity can can swell and these compartments are relieved of the pressure nursing care the five piece of the neuromuscular assessment because think about it what gets compressed here are blood vessels nerves and muscle so we already said that the patient might have decreased blood flow so cyanotic absent or diminished peripheral pulses they might have peristusia by pressure of these nerves and then they might be paralyzed because the muscle now can't move their ischemic so the five piece check for pain pallor paralysis peristusia and pulse so make sure that you review my physical assessment video if you have in trouble with these five piece and of course we always want to check vital signs identify patients at risk and what I didn't mention here is if this is the patient after a fasciotomy we want to do meticulous wound care and dressing changes as order to make sure that that fascia that is many times left open for weeks of at a time doesn't get infected because that can pose a whole other problem list here so thank you for watching this video on compartment syndrome as always the most important thing is staying on top of your patient especially if they come back from surgery which is also why we check their distal five piece so frequently in the post-op period sometimes every 15 minutes for a couple hours and every 30 minutes depending on whatever the mechanism of injury was to make sure that we detect the signs and symptoms early rather than later and the patient might have a bad outcome so thanks for watching please give me the thumbs up if you have enjoyed the video thanks for watching nursing school explain see you soon