tag:blogger.com,1999:blog-4082643038671225434.post2870228026684934956..comments2023-10-07T01:34:01.774-07:00Comments on Case of the Day: On CallCraighttp://www.blogger.com/profile/17072102331564743101noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4082643038671225434.post-4991308552623753272009-01-12T19:45:00.000-08:002009-01-12T19:45:00.000-08:00Yes, this notoriously elusive diagnosis is a fat e...Yes, this notoriously elusive diagnosis is a fat embolism.<BR/>-<BR/>On Call<BR/> <BR/>This is fat embolism syndrome, associated with long bone and pelvic fractures. The triad is hypoxemia, neurologic abnormalities, and petechial rash. About half of patients may require mechanical ventilation, and mortality is 5-15%. Supportive care is the mainstay of therapy.<BR/><BR/>Source: UpToDate.Craighttps://www.blogger.com/profile/17072102331564743101noreply@blogger.comtag:blogger.com,1999:blog-4082643038671225434.post-36809772203527022322009-01-12T17:34:00.000-08:002009-01-12T17:34:00.000-08:00lipid pulmonary embolism from the broken femurs.lipid pulmonary embolism from the broken femurs.Stephhttps://www.blogger.com/profile/08918230920210128668noreply@blogger.comtag:blogger.com,1999:blog-4082643038671225434.post-10215119858383107782009-01-12T15:30:00.000-08:002009-01-12T15:30:00.000-08:00fat embolism?fat embolism?Alexhttps://www.blogger.com/profile/06972701448751949861noreply@blogger.comtag:blogger.com,1999:blog-4082643038671225434.post-35060179808471017042009-01-09T18:24:00.000-08:002009-01-09T18:24:00.000-08:00Acute respiratory distress syndrome (ARDS) caused ...Acute respiratory distress syndrome (ARDS) caused by the trauma two days earlier. <BR/>The time line for trauma related ARDS is 24-48 hours which fits this case.<BR/>The breathing problems, low O2 levels and confusion are all consistent with ARDS.<BR/>The rash is a little puzzling. It could be petechiae associated with the ARDS but I would expect to see it more in the underarm area than in the head and neck.<BR/>It's possible this could be an adverse drug reaction or an opportunistic infection acquired in the hospital.<BR/>Since this was a motorcycle accident polytrauma is most likely.<BR/><BR/>In any case. He needs ICU, O2 and mechanical ventilation immediately.<BR/> <BR/>Chest X-ray to check for pulmonary contusion.CodeDoghttps://www.blogger.com/profile/05726583302760142582noreply@blogger.comtag:blogger.com,1999:blog-4082643038671225434.post-80695511796989180542009-01-09T10:37:00.000-08:002009-01-09T10:37:00.000-08:00Post traumatic Fat embolism...this one's a classic...Post traumatic Fat embolism...this one's a classic picture fulfilling 3 out of the 4 major Gurd's criteria.Res ipsa loquiterhttps://www.blogger.com/profile/15945245779105520545noreply@blogger.com