Which of the following statements about compartment syndrome care is correct?

• A. Splitting the cast can decrease external pressure
• B. Casting should never be modified
• C. Cold compresses help relieve swelling
• D. Urine output is irrelevant

Answer: (A)

Relieving external pressure is crucial in compartment syndrome. When swelling occurs inside a casted limb, the confined space elevates pressure and can squeeze blood vessels, cutting off blood flow to muscles and nerves. Splitting the cast along a seam immediately creates space for the swollen tissue, lowering external pressure and helping restore perfusion. If swelling persists, the cast may need to be loosened or removed to prevent ongoing ischemia and the need for surgical fasciotomy. Cold compresses don’t address the underlying pressure inside the compartment and can mask symptoms or worsen perfusion, so they aren’t the appropriate treatment. Urine output matters because it can signal muscle breakdown (rhabdomyolysis) and risk of kidney injury, so it’s a relevant part of monitoring the patient’s status during care.