TABLE 52-3 C OMPARISON

Characteristic Fat Embolism

OF

FAT E MBOLISM

AND

P ULMONARY E MBOLISM
Pulmonary Embolism

Pathophysiology

Onset of symptoms Signs and symptoms

Fat globules released from marrow after fracture(s) enter bloodstream and obstruct pulmonary circulation Usually 12-24 hr after injury Altered mental status Dyspnea Tachypnea Tachycardia Petechial rash Fever Restlessness Agitation Hypovolemia Shock Delayed immobilization of fracture Multiple fractures Crush injuries

Deep vein thrombus dislodges and obstructs pulmonary circulation Usually 4-10 days after trauma or development of thrombophlebitis but can occur much later Dyspnea Chest pain Apprehension Anxiety Cough Hemoptysis Tachypnea Tachycardia Fever Venous stasis Immobility Obesity Trauma Major surgery History of heart disease Age over 40 yr History of deep venous thrombosis, pulmonary embolism

Risk factors