Compartment syndrome Quiz: Ace Your Exams
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A 32-year-old man is brought to the emergency department after a high-speed motor vehicle accident. The patient’s left leg was pinned for more than 2 hours. He is complaining of severe pain in his left lower leg. Temperature is 37.2°C (89.0°F), blood pressure is 95/62 mmHg, pulse is 135/min, respiratory rate is 22/min, and oxygen saturation is 94% on room air. On examination, his leg is swollen and tense, with decreased sensation and muscle weakness. Passive dorsiflexion of the ankle and toes elicits severe pain in the leg. There are no apparent chest or abdominal injuries, open fractures, or signs of active bleeding, and his pelvis is stable. Initial laboratory results are shown below. IV fluids and broad-spectrum antibiotics are initiated. Radiograph of the left lower extremity is negative for fracture. Which of the following is the best next step in management?
| Laboratory value | Result |
| Complete Blood Count (CBC) | |
| Hemoglobin | 14.4 g/dL |
| White blood cell count | 12,700/mm3 |
| Serum chemistry | |
| Sodium | 138 mEq/L |
| Potassium | 5.3 mEq/L |
| Creatinine | 1.2 mg/dL |
| Blood urea nitrogen (BUN) | 20 mg/dL |
| Creatine phosphokinase (CPK) | 4,050 U/L |
| Lactic acid | 2.8 mmol/L |
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