Intracompartmental Pressure Monitoring Using a Handheld Pressure Monitoring System

Abstract

Introduction: We describe the correct technique for measuring compartment pressure with a handheld device to diagnose compartment syndrome.

Step 1 device preparation: Proper preparation of the handheld pressure monitoring device (Stryker Surgical, Kalamazoo, Michigan) is critical to ensure that the device performs appropriately.

Step 2 identification of the compartment of interest: The needle must be placed in the proper location to appropriately measure a compartment's pressure.

Step 3 injection: Inject saline solution from the pressure monitoring device to clear any soft tissue from the side port on the needle that could result in inaccurate pressure measurements.

Step 4 stabilization and pressure reading: The pressure must reach a stable state before it is recorded; different pressure thresholds for decompression have been recommended in the literature.

Step 5 repeat measurements: As mistakes can be made with any single measurement, accuracy may be improved by repeating steps 1 through 4 and averaging the results.

Step 6 additional compartments: After the reading is obtained, move on to any additional compartment(s) that need to be evaluated, repeating the steps listed above.

Results: The handheld intracompartmental monitoring device with a side-ported needle has been shown to be extremely accurate in the laboratory.IndicationsContraindicationsPitfalls & Challenges.

Figures

Fig. 1

Incorrect alignment of the syringe flanges prevents closure of the monitor’s lid.

Fig. 2

Correct alignment of the syringe flanges (in line with the device or horizontal) allows proper closure of the lid.

Fig. 3

An example of an air bubble that has not been evacuated appropriately from the device prior to use.

Fig. 4

Approaching the compartment of interest with the device and zeroing the device in the position of the planned trajectory of needle insertion into the compartment.