NURS 498 Lecture Notes - Lecture 1: Acute Tubular Necrosis, Myoglobinuria, Blood Pressure
20 Feb 2018
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Document Summary
Two basic types of compartment syndrome: decrease compartment size, resulting from restrictive dressing, splints, casts, excessive traction, or premature closure of fascia. Increase compartment size: related to fracture, bleeding, edema, chemical response to snakebite, or iv filtration. Ischemia can occur within 4 to 8 hours after onset: early recognition and treatment essential, regular neurovascular assessments, may occur initially or may be delayed for several days. 6 p"s are neurovascular assessments of impending compartment syndrome. Pain -- distal to injury that is not relieved by opioid analgesics and pain on passive stretch of muscle travelling through compartment. Pallor -- coolness and loss of normal colour of extremity. Pulselessness -- diminished/absent peripheral pulses: urine output must be assessed because there is a possibility of muscle damage, myoglobin released from damaged muscle cells precipitates as a gel-like substance, causes obstruction in renal tubules. Large amounts of myoglobin may result in acute tubular necrosis: acute tubular necrosis causes acute renal failure.
