When assessing a patient with compartment syndrome, which finding requires immediate attention?

When assessing a patient with compartment syndrome, the decreased pulse in the affected limb is a critical finding that indicates potential vascular compromise. Compartment syndrome occurs when increased pressure within a muscle compartment impairs blood flow, and a diminished pulse suggests that the blood supply to the limb is being severely restricted. This lack of blood flow can lead to tissue ischemia and necrosis if not addressed promptly.

Immediate attention is necessary because restoring blood flow is crucial to prevent irreversible damage to the muscles and nerves within the compartment. In this context, a diminished pulse is not only alarming but serves as a clinical sign that intervention, potentially including surgical fasciotomy, may be required to relieve pressure and restore circulation.

The other findings, while they can be concerning, do not indicate the same level of urgency. The presence of a fever may suggest an infection, persistent limb swelling can indicate inflammation or fluid accumulation, and minor tingling sensations can point to neuropathy or mild nerve compression. However, none of these findings directly threaten the viability of the limb in the immediate way that a decreased pulse does.