The phrase “CMS intact” is medical shorthand used primarily in emergency, trauma, and orthopedic care. It documents a rapid assessment performed by healthcare providers to confirm that the nervous and vascular systems in a limb are functioning normally following an injury or medical intervention. CMS is an abbreviation for Circulation, Motor function, and Sensation. Evaluating these three systems is a standard procedure to quickly assess potential neurovascular compromise, especially in the hands and feet.
Decoding the Acronym: Circulation, Motor, Sensation
The letter “C” stands for Circulation, which refers to the blood flow to the affected extremity. Adequate circulation ensures that tissues are receiving necessary oxygen and nutrients and that waste products are being removed. The assessment examines the health of the arteries and veins that supply the limb.
The “M” represents Motor function, which is the patient’s ability to move the extremity or digits. This component tests the integrity of the motor nerves and the muscles they control. The patient must be able to actively move the area being tested, demonstrating that nerve signals are reaching the muscles.
The “S” denotes Sensation, reflecting the patient’s ability to feel touch, pressure, or pain. Sensation testing assesses the function of the sensory nerves that transmit information back to the central nervous system. An intact sensory system means the patient can accurately perceive and localize different stimuli.
The Assessment Process: How CMS is Checked
Checking Circulation begins with a visual inspection of the skin’s color and temperature. Providers then palpate pulses distal to the injury site, such as the radial pulse in the wrist or the dorsalis pedis and posterior tibial pulses in the foot. The most common test is capillary refill, where pressure is applied to a nail bed until it blanches. A normal refill time, typically less than two seconds, confirms blood flow is reaching the extremity.
Motor function is assessed by asking the patient to perform specific actions, such as wiggling their fingers or toes. The provider may ask the patient to push and pull against resistance to evaluate strength and range of motion in the digits and joints. This quickly determines if the nerves responsible for movement are functioning correctly.
To test Sensation, the healthcare provider uses a light touch or a pinprick to see if the patient can feel the stimulus and identify its location. The patient might be asked to close their eyes and specify which finger or toe is being touched. Intact sensation is recorded when the patient’s perception of these stimuli is normal and equal to the unaffected limb.
Clinical Significance: Why “Intact” Matters
Documenting “CMS intact” confirms the patient has not suffered a neurovascular injury. This finding is important following a fracture, joint dislocation, or orthopedic surgery, where swelling and trauma can compress nerves and blood vessels. Serial assessments are performed regularly because an intact status can change quickly if swelling increases.
A compromised or “non-intact” CMS finding is a medical emergency that indicates potential tissue damage due to loss of blood supply or nerve function. Signs of compromise include absent or diminished pulses, delayed capillary refill, or cool and pale skin, which signal a serious vascular injury or arterial blockage. The inability to move or feel the extremity suggests nerve damage that requires urgent attention to prevent permanent disability.
A non-intact CMS can indicate Compartment Syndrome, a condition where pressure builds up within the muscles, impairing blood flow. Muscle and nerve tissue can die within hours without immediate surgical intervention. The CMS assessment guides immediate treatment decisions to protect the limb’s viability.