Measuring Compartment Pressure

We first review how to setup and use the Stryker intracompartmental pressure monitor device, then we review the anatomical compartments and where to insert the needle for each compartment of the lower leg and forearm. Presented by Jessica Mason, MD and Walid Hamud, MD.

Phu Manh T., M.D. -

patient will be in a lot of discomfort already with CPS. any local anesthesia given or if it's even considered?

Jess Mason -

Yes, we inject some local anesthetic at the very beginning of the video. Your patient likely will also need some systemic analgesia.

Jonathan G. -

this was an awesome review. thank you!

Mazdak M., Dr -

Could we use the arterial line set if striker needle not available?

Jess Mason -

Yes you can. I plan to make a video on that in the future.

Katherine B. -

very high yield - thank you

Dharmesh S. -

In a pinch - you can use a CSF manometer loaded with saline and a 3-way connection.
The CSF manometer connected to 3-way stopcock. Saline is injected to fill up the manometer via the 3-way, and the stop-cock is closed to the syringe which is then disconnected. Now you have the manometer filled with saline. A needle is attached to the 3-way tubing. Open the stop-cock to needle, allowing saline to flow from manometer and push out the small amount of air in the needle. Close to the needle once air is out. Insert the needle into the muscle compartment. Keeping the "zero" mark on manometer level with the skin insertion point of the needle in the muscle compartment and holding the manometer perpendicular to the ground, the 3-way is opened to the needle (patient) again. Saline meniscus level in the manometer will start dropping, and stabilize at the compartment pressure. Now you have compartment pressure in "cm of water".
Conversion - 3 mm Hg = 4 cm Water (approx).
In resource limited settings in India - we have also used IV set taped to a meter rule as our manometer.

Sierra D. -

So is the correct number to use for compartment pressure the reading acquired when the muscles in the compartment are passively stretched, rather than when they are in a neutral position?

Jess Mason -

You should use the number when the compartment is relaxed -- not stretched. The purposes of stretching the compartment is to confirm you are in the right compartment you intended to check, because you will see the number rise.

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