0071643192.pdf

■ Needle placement is perpendicular to the skin:

■ Lower Leg (see Figure 19.11)

■ Anterior compartment: Needle entry point is 1 cm lateralto the

anterior border of the tibia.

■ Deep posterior compartment: Needle entry point is just posterior to

the medial border of the tibia.

■ Lateral compartment: Needle entry point is just anterior to the pos-

terior border of the fibula

■ Superficial posterior compartment: Needle entry point is 3–5 cm

on either side of a vertical line drawn down the middle of the calf

at the junction between the proximal and middle thirds of the

lower leg.

■ Forearm (see Figure 19.12)

■ Volar compartment: Needle entry point is just medial to the pal-

maris longus.

■ Dorsal compartment: Needle entry point is 1–2 cm lateral to the

posterior aspect of the ulna.

■ Pressures can be measured either with an arterial line pressure measure-

ment system or with a Stryker Intracompartmental pressure monitor system.

COMPLICATIONS

■ Infection, pain, inaccurate readings, exacerbation of compartment syndrome

by injection of fluid into compartment

INTERPRETATION OFRESULTS

■ Falsely elevated pressures may be a result of needles placed into tendons

or fascia, plugged catheters, or faulty electronic systems. Falsely low read-

ings may result from bubbles in the lines or transducer, plugged catheters,

or faulty electronic systems.

PROCEDURES AND SKILLS

Anterior tibial artery

and deep peroneal nerve

Superficial

peroneal

nerve

Lateral

compartment

Superficial

posterior

compartment

Anterior compartment

Deep compartment

Posterior tibial artery

and nerve

Sural cutaneous

nerve

FIGURE 19.11. The four compartments of the lower leg.

(Reproduced, with permission, from Tintinalli JE, Kelen GD, Stapczynski JS. Tintinalli’s

Emergency Medicine: A Comprehensive Study Guide, 6th ed. New York: McGraw-Hill,

2004:1747.)