Suspected Compartment Syndrome
Crush injury, fracture, reperfusion, snake bite
All Pathways
Plastic SurgeryDiagnostic
Upper Extremity Compartment Syndrome Algorithm
Upper Extremity Compartment Syndrome Algorithm: Suspected Compartment Syndrome → Clinical Assessment: 6 P's → Clinical Diagnosis Clear? → Emergent Fasci...
Pathway Overview
8 steps
Algorithm Steps
8 total
01Start 02Action Clinical Assessment: 6 P's
Pain out of proportion, Pain with passive stretch
- Pressure (tense compartments)
- Paresthesias
- Paralysis (late)
- Pulselessness (very late)
03Decision Clinical Diagnosis Clear?
04End Emergent Fasciotomy
Do not delay for pressure measurement if clinically obvious
05Action Measure Compartment Pressure
Stryker device or arterial line setup
06Decision Delta Pressure (DBP - CP)
- <30 mmHg = Positive
- >30 mmHg = Negative
07End Fasciotomy Indicated
Forearm: volar + dorsal incisions; Hand: thenar, hypothenar, interosseous
08Action Serial Monitoring
Repeat exam Q1-2h, repeat pressure if concern
- Path rejoins step 03Shared downstream outcome
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
USAUUKEU
UK: BOAST guidelines similar
US: AAOS guidelines, delta pressure <30 mmHg threshold
Version 1Next review: 2028-01-01
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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