Advanced Trauma Life Support ATLS Student Course Manual 2018

SECONDARY SURVEY AND RELATED ADJUNCTS 177
A
C
B
D
n FIGURE 9-5 Depth of Burns. A. Schematic of superficial partial-thickness burn injury. B. Schematic of deep partial-thickness burn.
C. Photograph of deep partial-thickness burn. D. Photograph of full-thickness burn.
to the burn, a pressure of > 30 mm Hg within the
compartment can lead to muscle necrosis. Once the
pulse is gone, it may be too late to save the muscle. Thus,
clinicians must be aware of the signs and symptoms of
compartment syndrome:
••
Pain greater than expected and out of
proportion to the stimulus or injury
••
Pain on passive stretch of the affected muscle
••
Tense swelling of the affected compartment
••
Paresthesias or altered sensation distal to the
affected compartment
A high index of suspicion is necessary when patients
are unable to cooperate with an exam.
Compartment syndromes may also present with
circumferential chest and abdominal burns, leading
to increased peak inspiratory pressures or abdominal
compartment syndrome. Chest and abdominal escharotomies
performed along the anterior axillary lines
with a cross-incision at the clavicular line and the
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