Epidem/Etiology
Fractures to this type of bone are most likely to cause fat embolism
What are long bones?
A fat emboli lodging in the pulmonary capillaries increases pressure in a chamber in the heart
What is the right ventricle?
(Also contributes to pulmonary HTN)
A patient's LOC may fall due to this common symptom of fat embolism
What is lethargy, confusion, or coma?
This diagnostic tool will be mostly normal unless bilateral infiltrates appear
What is a chest X-Ray?
Symptoms of fat embolism syndrome appear around this time.
24-72 hours post-injury
Though 90% of severe skeletal injuries may have fat emboli, only 10% actually show any clinical findings known as this syndrome.
Fat embolism syndrome
How fat emboli occlude vasculature (two ways)
What is platelet aggregation and direct occlusion?
Considered the most common symptom of fat embolism.
What is hypoxia? (Tachypnea, dyspnea, diffuse crackles in chest, cyanosis)
What is supportive care?
These are three common bone fractures that may lead to FE
What are the thigh, tibia, and pelvis?
This is the fat-rich region of bone.
Adhesion of these to fat globules leads to aggregation and an abnormal lab finding, thrombocytopenia
What are platelets?
A urine or sputum sample may show this result.
What are fat droplets?
Although men have more FE than women overall, post-menopausal women and patients w/ muscular dystrophy are examples
What are high-risk groups?
Think twice about this cosmetic procedure that may have risk of fat embolism.
Liposuction
Along with previous fractures, this age is a risk factor
Release of these molecules from fat globules exacerbate endothelial cellular injury
What are free fatty acids?
A characteristic rash is mainly seen on the axilla, chest wall, head, neck, conjunctiva, and buccal mucosa
What is the petechial rash?
(Also related to onset of thrombocytopenia and anemia)
There is a % mortality w/ symptomatic fat embolism.
What is 5-15%?
It's not just fractures that lead to fat embolism.
What is soft tissue injury, pancreatitis, osteomyelitis, orthopedic surgery, or bone marrow transplant?
What is elevated A-a gradient?
A full blood count is abnormal due to these two results
What is thrombocytopenia and anemia?