Fat Embolism Syndrome.

Fat embolisms are fat globules that enter the circulatory system, typically through trauma, that may or may not lead to the development of fat embolism syndrome (FES), a rare and ill-defined diagnosis that can cause multiorgan failure and death. The exact mechanism of FES remains unknown, although several theories support the involvement of inflammatory response activation that contributes to characteristic clinical findings. There is no gold standard for diagnosis of FES, and treatment at this time remains primarily supportive. Early recognition of FES symptoms is the most beneficial nursing intervention for combating this serious disorder.

Orthopedic complications. Compartment syndrome, fat embolism syndrome, and venous thromboembolism.

Specialized education in the care of orthopedic patients includes an understanding of the common complications for which patients require monitoring. With a socioeconomic backdrop of decreasing hospital stays and prospective payment, patient care must be managed proactively. For all three complications presented, there are unique sets of risk factors that, when present, contribute to a high index of suspicion for morbidity. Clusters of symptoms have also been discussed representing the expected normal patterns. With this knowledge as a foundation, clinical application is essential to incorporate other salient aspects of individual situations. Nurses diagnose and treat human responses to health problems. The end result of human responses to injury or orthopedic conditions can be the development of complications. Stringent adherence to patient monitoring protocols can promote timely nursing interventions to prevent, minimize, or detect complications or treatment side effects. Although definitive treatment is often physician directed, nurses are in a key role to impact final patient outcomes.

Fat embolism syndrome: a variant of ARDS (continuing education credit).

Fat embolism syndrome (FES) is a relatively uncommon, life-threatening sequela of long-bone fractures. Occurring 24 to 48 hours postinjury, the syndrome manifests as hypoxemia, confusion, and petechiae. The pathophysiologic changes in the lung are consistent with those of ARDS. Nursing priorities include an awareness of risk factors, familiarity with signs and symptoms, and a high index of suspicion in patients with multiple long-bone fractures.

Early assessment and management of musculoskeletal injuries.

Permanent disability following musculoskeletal injury can often be prevented with prompt recognition and appropriate temporary or definitive management. This article has highlighted some specific injuries and guidelines for emergency treatment.

Pulmonary fat embolism: a complication of fracture.

Medical personnel must be aware of the possibility of fat embolism as a complicating factor of fractures. Ambulance, emergency room, orthopedic, and intensive-care personnel may frequently be involved in the care of these patients. Fat embolism should be suspected any time a patient exhibits bizarre mental, pulmonary, or circulatory symptoms following a fracture. Prevention may be achieved by as near immobilization of a fracture as possible. When fat embolism does occur, the course of the illness may or may not be complex. The treatment is supportive and the patient should be made as comfortable as possible.