NREMT Paramedic Cognitive ExamTraumaMedium
A 20-year-old male is experiencing severe pain to his right forearm after a motorcycle collision. His forearm is swollen, tense to palpation, and he complains of numbness and tingling in his fingers. Distal radial pulse is present but weak. These findings are most concerning for which of the following conditions?
- AUlnar nerve laceration
- BRadial head dislocation
- CCompartment syndrome
- DDeep vein thrombosis
Show answer & explanationAnswer & explanation
Correct answer: C. Compartment syndrome
The signs and symptoms (severe pain, swelling, tense compartment, paresthesia/numbness, weak distal pulse) in the setting of trauma are classic indicators of compartment syndrome. This is a surgical emergency where increased pressure within a confined fascial compartment compromises circulation and nerve function.
Why the other options are wrong
- A. Ulnar nerve laceration would cause specific sensory and motor deficits in the ulnar distribution, but not the diffuse tense swelling and pain characteristic of compartment syndrome.
- B. Radial head dislocation would primarily cause elbow pain and deformity, not diffuse forearm swelling and tense compartments with paresthesias.
- D. Deep vein thrombosis typically presents with swelling and pain, but usually without the extreme tenseness to palpation, paresthesias, or weak pulse associated with compartment syndrome in an acute trauma setting.
Compartment Syndrome
A condition in which increased pressure within a confined fascial compartment compromises the circulation and function of the tissues within that compartment.
- Often follows trauma, fractures, or crush injuries.
- Key signs: '6 Ps' - Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia (though not all may be present early).
- Surgical emergency requiring fasciotomy.
Memory trick: Compartment's Cruel Clench: Pressure's Pains.