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Compartment Syndrome

Compartment syndrome

Most of our muscles are divided into compartments surrounded by fascia which is not very giving (the silver skin for those who hunt). Compartment syndrome is a painful condition that occurs when pressure within the muscle compartment builds to dangerous levels.
This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.
Small nerve and muscle cells can die leading to permanent disability, weakness, and numbness.

Classic signs and symptoms

  1. Muscle pain and cramping
  2. Swelling of the affected limb
  3. Weakness and decreased range of motion in the affected limb
  4. Tingling, burning or numbness

Two types to consider:

Non-Traumatic/Exertional

  • The pain and swelling are caused by physical exertion. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop non traumatic compartment syndrome.
  • This may be relieved by discontinuing the physical activity and rest. It is commonly mistaken as shin splints in the lower leg.
  • This may become a surgical emergency and require surgical treatment.

Traumatic 

  • Caused by a variety of things:
    • Broken bone
    • Badly bruised muscle
    • Crush type injuries
    • Anabolic steroid use
    • Constricting bandages or clothing
  • Traumatic compartment syndrome is considered a surgical emergency and requires surgical treatment.

Watch Outs:

  • A swollen, painful limb that does not improve with rest can be a sign of a significant emergency and should be treated in an emergency department.
  • Any numbness or weakness in the limb should mandate transport for professional medical evaluation.

Discussion Questions:

  • Your leg is swollen and sore after a long day of physical work.  What should you do?
  • Your crew member has been resting his swollen leg for a couple hours and now says it is tingling and cramping, what are your next steps?
     

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NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Book are now available for Ramp Manager (RAMP).

The Performance Support Package for this position was developed as part of the Incident Performance and Training Modernization effort. These resources support trainees, qualified personnel, and evaluators in their respective roles.

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The Risk Management Committee (RMC) has issued Safety Bulletin 26-001: Rhabdomyolysis in Wildland Firefighters. Research from 2016 to 2025 shows that 88 cases of rhabdomyolysis (rhabdo) were reported. Analysis of reports from eSafety, the Safety Management Information System (SMIS), and the Wildland Fire Lessons Learned Center (LLC) indicates that rhabdo is common during this time of year due to Work Capacity Tests and contributing factors such as weather, hydration, nutrition, and medication or supplement use.

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