Emergency medical services
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These six questions may make it easier to guide your steps as critical minutes pass while treating your tachycardic patient. Ultimately, local protocols and the contents of your drug box may limit some of your choices, but good decisions can start the process. Adequate oxygenation, establishing IV lines and diagnosing specific rhythms are the first steps toward successful treatment of your next patient.
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Compartment syndrome is a limb-threatening and occasionally life-threatening injury. It occurs whenever the tissue pressure (referred to as interstitial pressure) within a closed anatomic space is greater than the perfusion pressure. Untreated, compartment syndrome leads to tissue necrosis, permanent functional impairment and, if severe in large compartments, renal failure and death. ⋯ In many cases, such an injury would be referred to as a "stinger" (a temporary neurological deficit due to a sudden and excessive stimulation of a neurologic plexus or junction). But this patient had more swelling in the compartment, resulting in a lack of circulation manifested by a cool extremity, poor capillary refill and decreased pulse oximetry. Luckily, this officer recognized the need for medical evaluation of what appeared to be a minor injury and was returned to duty with no permanent impairment.