Assessment of compartment pressures can be performed using
an aseptic technique through inserting a slit catheter (like that used
for arterial pressure monitoring) into the compartment suspected of
ACS (for example the anterior compartment of the lower leg). This
should be connected to an arterial line transducer via a static column
of saline solution to obtain measurements. Pressure monitoring can
be performed by one-off measurements or by continuous monitoring.
Alternatively, there are also single use compartment pressure devices
available on the market. Correct needle placement can be checked
by performing manoeuvres that increase the compartment pressure
(such as bi-manual pressure close to the needle site or dorsi and
plantar flexion of the foot). Normal compartment pressure is usually
10-12mmHg (Farrow, etal., 2011). When the compartment pressure is
30mmHg or greater, a fasciotomy is recommended (Singisetti, 2009).
However, perfusion pressures are relative to diastolic pressures,
therefore in some patient groups a differential compartment pressure
of less than 30mmHg below diastolic blood pressure is indicative
of ACS. Assessment of compartment pressures is considered to
have high sensitivity and specificity for accurately diagnosing ACS