Reflective accounts

Acute limb compartment syndrome

A CPD article improved Tina Price’s knowledge of diagnosing acute limb compartment syndrome.

A CPD article improved Tina Price’s knowledge of diagnosing acute limb compartment syndrome.

Picture: SPL

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article provided useful information for nurses on acute limb compartment syndrome (ALCS). It discussed the severity of ALCS and the urgency of diagnosing the condition, as well as describing the signs and symptoms.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

ALCS is a potentially life-threatening condition. The raised muscle pressure caused by ALCS, and the subsequent suboptimal perfusion, can result in tissue hypoxia, local tissue damage and muscle necrosis.

As well as affecting the limbs, ALCS can also affect muscles in the abdomen, a factor I had not previously considered. 

I am aware that ALCS is a medical emergency that, if not recognised early enough, can cause permanent nerve and muscle damage, loss of limbs, sepsis and potential death. The article also focused on rhabdomyolysis, a condition I was not familiar with, which causes the skeletal muscle to break down as a result of ischaemia and necrosis. 

The article discussed how assessing the limb for pallor and/or mottling is an unreliable sign of ALCS, and is more likely to indicate other types of vascular compromise. 

How did you change or improve your practice?

In my role, I often mentor nursing students and, although I include the assessment of ALCS in my teaching, I have not encountered any nursing students who were aware of this condition. Reading the article has increased my knowledge of ALCS and led me to review the advice I provide to nursing students. I will encourage them to pay more attention to the patient’s description of their pain and to prioritise this as the most important diagnostic tool. 

The article has prompted me to use a pain assessment tool to assist in recording any deterioration in the symptoms of ALCS; I will also ensure that I frequently monitor and document the colour of the patient’s affected limb. I intend to undertake further research into the development of compartment syndrome in the abdomen. 

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

The Code states that nurses should prioritise people by ensuring that their care and safety is the nurse’s main concern. The article discussed the need for nurses to respond immediately if ALCS is suspected. 

Another theme of The Code is preserving safety and ensuring that patients are protected. The article emphasised that ALCS is a life-threatening condition, and it explains how to identify the symptoms of ALCS and document any observations.

Tina Price is a staff nurse, outpatients, Sandwell General Hospital, Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, England

This reflective account is based on NS890 Limbert E, Santy-Tomlinson J (2017) Acute limb compartment syndrome in the lower leg following trauma: assessment in the intensive care unit. Nursing Standard. 31, 34, 61-71  

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