Compartment syndrome Quiz: Ace Your Exams

A 34-year-old man presents to the emergency department with severe pain in his right forearm, which started 3 hours ago after experiencing an electrical injury at work. He was working with high-voltage equipment when he accidentally came into contact with an exposed live wire. He also reports numbness in the affected limb. Temperature is 36.7°C (98.1°F), blood pressure is 135/85 mmHg, pulse is 118/min, respiratory rate is 18/min, and oxygen saturation is 98% on room air. On physical examination, the patient's right forearm is tense and “wood-like”, significantly swollen, and pain is elicited with passive stretching of the wrist and fingers. Sensory and motor examinations both show mild deficits. Laboratory evaluation is significant for potassium of 5.3 mEq/L, CPK of 3050 U/L, and lactate levels of 3.0 mmol/L. ECG is significant for sinus tachycardia. Intravenous fluids are initiated. Which of the following is the most appropriate next step in management?