QuestionSBA
QuestionChoice
Incorrect, this patient needs fasciotomy to alleviate the intracompartmental pressure. This is a medical emergency, to prevent irreversible damage to the neurovascular supply and ultimately amputation.
10007155
e
Email the orthopaedic consultant to see the patient first thing tomorrow
QuestionChoice
This is compartment syndrome. It can occur following fractures and is characterised by increased pressure within a confined space. This causes tissue perfusion to be compromised, resulting in necrosis. It is highlighted by pain, parasthesiae, pallor, pulseless, paralysis, poikilothermia. Prompt alleviation of the intracompartmental pressure is essential to avoid tissue necrosis.
10007151
a
Fasciotomy
QuestionChoice
Incorrect, this patient needs fasciotomy to alleviate the intracompartmental pressure.
10007152
b
Begin aggressive fluid resuscitation
QuestionChoice
Incorrect, this patient needs fasciotomy to alleviate the intracompartmental pressure, treating the cause of his pain. Although adequate analgesia should also be prescribed, it is noted that he is already on IV morphine without significant response.
10007154
d
Prescribe oramorph
QuestionChoice
Incorrect, this patient needs fasciotomy to alleviate the intracompartmental pressure, treating the cause of his pain. Although adequate analgesia should also be prescribed, it is noted that he is already on IV morphine without significant response.
10007153
c
Prescribe IV paracetamol
Concept
Chapter
2693
4575
Compartment syndrome
Topic
161
Emergency Medicine
13977
A 17-year-old rugby player is assessed on the orthopaedic ward. He returned from theatre after receiving a femoral intramedullary nail around 4 hours ago, but is now complaining of worsening pain in his thigh. It is not responding to IV morphine.

On examination, there are no visible changes to the lower limb, but his injured limb is markedly weaker, with a tingling feeling spreading down into the foot.

The bandaging has already been removed. Which of the following is the best next step?
a