-compartments are areas of the body in which muscle, blood vessel, and nerves are contained within fascia (inelastic tissue surrounding groups of muscle and vessels and nerves).
-ACS serious condition in which pressure reduces circulation to that area.
-lower leg and forearm are most common
-it is a complicating process that causes edema putting pressure on the nerve endings causing pain
-perfusion to the area is reduced and ischemia occurs
-fracture is the cause in 75% of cases
-tight, bulky dressings and casts are an example of external pressure
-internal pressure could be blood, fluid accumulation
-this is a serious issue and needs to be addressed. infection, motor weakness of that limb, less blood below the compartment, renal failure, and even amputation
-early recogniztion of ACS prevents loss of function
-acs can begin 6 to 8 hours post an injury or take up to 2 days to appear.
-fasciotomy or opening of the fascia may be performed through the skin and relieves pressure and restores circulation. the open wound is packe3d and dressed daily
- Assess the six Ps; pressure, pain, paraylsis, paraesthesia, pallor, pulessness
-fat globules are released from yellow bone marrow into the bloodstream within 12 hours to 48 hours
-these globules clog small blood vessels that supply organs
-lungs is common with impaired perfusion
-usually seen with fractures but can also be seen with total joint replacement
-20 through 40 and 70 through 80 men greatest risk
-EARLIEST MANIFESTATIONS = low o2 levels, dyspnea, tachypnea, headache, lethargy, agitation, confusion, seizures, visual changes, decreased LOC, petechiae is classic but late sign on the neck, arms, or chest
-obstruction of pulmonary vascular bed by fat globules.
-95% from fractures of long bones, within 48 hours
-altered mental status (earliest sign), increased RR,PR,Temp, chest pain, dyspnea, crackles, petechiae
-treatment includes bedrest, gentle handling, oxygen, hydration, steroid therapy and fracture immobilization
blood clot embolism:
-obstruction of pulmonary artery by a blood clot or clots
-85% from DVT in legs or pelvis, can occur anytime
-same assessment findings as fat embolism - the petechiae
-preventive measures (move, stockings), bedrest, o2, mechanical ventilation, anticoagulants, thrombolytics, surgery?