Compartment Syndrome In Children

WHAT YOU SHOULD KNOW:

• Compartment syndrome (SIN-drohm) is a condition that occurs when pressure increases within a compartment (closed space) in the body. Inside this compartment are muscle tissues, nerves, and blood vessels that are enclosed by a fascia. The fascia is a thick layer of special protective tissue that does not expand (grow). Compartment syndrome happens when there is swelling in the compartment. This swelling inside the compartment puts pressure on the muscles, blood vessels, and nerves. Blood flow inside the compartment may be blocked and lead to muscle and nerve injury. Over time, the injured limb (arm, leg, hand, or foot) may not work anymore.
  
  
• Common signs or symptoms of compartment syndrome include severe pain, swelling, and weakness. Your child may also have tingling, tenderness, and a tight or full feeling in the injured muscles. His skin may be pale and he may have trouble moving the injured limb. Blood and urine tests, muscle compartment measurement, and laser doppler flowmetry may be used to diagnose compartment syndrome. Treatment may include removing a tight cast, medicines for pain, or surgery to decrease the pressure and swelling.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Medicine used to treat compartment syndrome may cause nausea (upset stomach), vomiting (throwing up), or stomach ulcers (sores). Your child may bleed or get an infection if he has surgery. If this condition is not treated as soon as possible, your child's muscles and nerves may have permanent damage. Blood supply may decrease to the injured area. Your child's arm or leg may get weak, and he may have problems moving it.

If this condition is not treated, your child may need an amputation (removing all or part of the injured arm or leg). Finding and treating compartment syndrome as soon as possible is very important. Call your child's caregiver if you have concerns about his condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Activity:

At first your child may need to rest in bed. Caregivers may help him elevate his limb at the level of his heart. Your child's caregiver will tell you when it is OK to get him out of bed. Call your child's caregiver before getting him up for the first time. If he ever feels weak or dizzy, have him sit or lie down right away.

Blood tests:

Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Hyperbaric oxygen therapy:

Hyperbaric oxygen therapy is used to put more oxygen into your child's body. The oxygen is given under pressure so his blood and tissues can receive it faster. He may be put into a tube-like chamber called a hyperbaric or pressure chamber. Your child will be able to see you and his caregivers and talk with you through a speaker. He may need to have this therapy more than once.

Medicines:

Your child may need one or more of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Diuretics: These medicines will help decrease swelling in your child's body by making him urinate more often.
  
  
• Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Tests:

He may have one or more of the following:

• Doppler flowmetry: This test checks the flow of blood in your child's muscles. This may help caregivers feel or hear the blood flow in the compartment.
  
  
• Magnetic resonance imaging scan: This test, also called an MRI, uses magnetic waves to take pictures. During an MRI, pictures are taken of your child's bones, muscle, joints, and blood vessels. He will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.
  
  
• Muscle compartment pressure measurement: The increased pressure within the compartment may be measured with special tools. A long needle attached to a special machine that measures pressure is put into the injured muscle.
  
  
• Near infrared spectroscopy: This test uses infrared (light beam) to show changes in the muscle.
  
  
• Scintigraphy: This is a test to look at the flow or movement of blood through the compartment area. Your child will be given a small amount of dye in an IV. Pictures are then taken of your child's blood vessels, muscles, or bones.
  
  
• Urine test: A sample of your child's urine is collected and sent to the lab for tests. This may help caregivers know when muscles are breaking down and if his kidneys are affected.

Treatment options:

Your child may need one or more of the following:

• Brace or crutches: Your child may need to wear a brace to keep his limb from moving. This brace may correct, support and protect the body part. Caregivers may also tell your child to use crutches to decrease stress and strain on his legs.
  
  
• Surgery: Caregivers may do a fasciotomy to decrease pressure and swelling. A long incision (cut) may be done in the fascia of the injured compartments.
  
  
• Rehabilitation: This is a program that helps your child bring back his limb's normal range of motion and strength. A physical or occupational therapist may exercise his arms, legs, and hands. They may also teach him new ways to do daily activities and care for himself. This therapy teaches your child special skills for bathing, dressing, or eating.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Compartment Syndrome In Children (Inpatient Care)