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Fat Embolism

 

 

Signs

 

  • Hypoxemia (most common early sign)

  • Neurological abnormalities (majority of patients)

  • Petechial rash (only 20-50% of patients; usually on conjuctiva, oral mucosa, skin folds of neck & axillae)

 

 

Management

 

  • Supportive treatment:

    • Respiratory support: intubation/ventilation, treat as ARDS (lung protective strategy)

    • Hemodynamic support: fluid resuscitation, vasopressors, invasive monitors, TEE

    • Steroids: no strong evidence but consider in refractory cases

  • Reduce incidence/severity:

    • Early immobilization of fractures

    • Operative correction rather than traction alone

    • Limitation of the intraosseus pressure during orthopedic procedures

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