UMEM Educational Pearls

Category: Pediatrics

Title: Compartment Syndrome in Pediatrics

Keywords: orthopedics, compartment syndrome (PubMed Search)

Posted: 9/20/2013 by Jenny Guyther, MD (Updated: 9/27/2022)
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We have learned how to diagnose compartment syndrome in adults, but how do you determine the early warning signs in a nonverbal or even frightened child?  

Rising compartment pressures are related to increasing anxiety and agitation in children.  A Boston study in 2001 showed that increasing pain medication requirements were detected 7 hours earlier than a vascular exam change.  90% of the patients with compartment syndrome in this study reported pain, but only 70% had another ‘P” (pallor, parasthesia, paralysis or pulselessness).

This has led to the proposal of the 3 “A”s for early identification of compartment syndrome in children: increasing anxiety, agitation and analgesia requirement.

References

Noonan and McCarthy.  Compartment Syndrome in Pediatric Patients.  Journal of Pediatric Orthopedics.  Vol 30.  No 2.  March 2010.