If compartment pressure measurement is undertaken, and the difference between diastolic pressure and compartment pressure is less than 30 mmHg in any compartment, an immediate (within 1 h), bilateral four-compartment fasciotomy should be undertaken.If initial assessment is equivocal, for example in a sedated/unconscious patient, in whom adequate clinical assessment cannot be undertaken, and there is a high index of suspicion, measurement of compartment pressures may be used to confirm or exclude compartment syndrome.There should be a low threshold for reassessment in patients whose symptoms persist or deteriorate.Treatment should be under way within 1 h of diagnosis. If clinical assessment confirms a definite or likely diagnosis of WLCS, this is a limb/life-threatening surgical emergency requiring immediate decompression by open four-compartment fasciotomy.If WLCS is suspected, immediate referral should be made to the orthopaedic or vascular surgery team, according to local protocols.
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