Post-op Low Sats Flashcards
What are some potential causes of post-operative low saturations?
Anaesthetic - Depresses respiratory drive
Pain Medication - Opiods depression causing decreaseed oxygenation
PE - usually occurs 3-5 days post-operatively
Anaemia - Blood loss leading to SOB post-operatively
Post-operative hypoexemia - Pre-exisiting lung conditions
Chest infection - LRTI following operation
Cardiac - MI/Ischemia
Fat Embolism - Following major trauma,
Missed trauma - Rib fractures, pneumothorax, tension pneumothorax
What are fat embolisms, how do they developed?
Fat embolisms are when fatty tissue is released into systemic circulation.
Mechanical - Fatty tissue is released directly into systemic venous circulation as a result of trauma
Biochemical - Inflammatory reponse to trauma leads to release of free fatty acids into system circulation
What criteria can be used to diagnose a fat embolism?
Major criteria = Petechial Rash, Respiratory Insufficiency, Cerebral Involvement
Minor criteria = Tachycardia, Pyrexial, Retinal Changes, Jaundice Thrombocytopaenia, Anaemia, Raised ESR, Fat macroglobulinaemia
When do fat embolisms develop?
Usually after long bone fractures or following routine orthopaedic procedures.
What are the clinical signs of fat embolism
Worsening shortness of breath, however other symptoms include confusion, drowsiness, or the development of a petechial rash
How do we manage a fat embolism?
Splinting of fracture/Fixation of long bone fracture
Potential complications
ARDS
Cerebral hypoxia
Managment fat embolism
Largely supportive. Patient may need escelation of care to HDU/ICU for ventilatory support.