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Acute compartment syndrome — RCPSC EM MCQ

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HardMusculoskeletalAcute compartment syndromeRCPSC EM

A 35-year-old construction worker presents CTAS 2 after a crush injury to the forearm. Pain is severe despite fentanyl, fingers are held flexed, passive finger extension worsens pain, and the forearm is tense. Radial pulse is present and capillary refill is 2 seconds. What is the most appropriate next step?

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Correct answer: A — Call orthopaedics urgently for fasciotomy assessment

Compartment syndrome is a clinical diagnosis; preserved pulses do not exclude it. Severe pain with passive stretch and tense compartments require urgent surgical decompression assessment.

Reference: Royal College Emergency Medicine exam format and training experiences