Clinical diagnosis (do not delay management to obtain the following)

If diagnostic uncertainty: measure intracompartmental pressure + diastolic blood pressure

• Diastolic blood pressure - compartment pressure <30 mmHg suggest increased risk → surgical decompression is generally indicated
• Absolute compartment pressure >40 mmHg + clinical symptoms → urgent surgical decompression

Immediate management:

• Release all circumferential dressings to skin
• Elevate the limb to heart level

 Surgical decompression should be preformed within 1 hour

• Immediate open fasciotomy (the wound typically left open for delayed closure)
• Excise any necrotic muscle
• Re-exploration at ~48 hours (or earlier if clinically indicated)

 
 

BOAST Diagnosis and Management of Compartment Syndrome of the Limbs