Post-op Low Sats Flashcards

1
Q

What are some potential causes of post-operative low saturations?

A

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

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2
Q

What are fat embolisms, how do they developed?

A

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

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3
Q

What criteria can be used to diagnose a fat embolism?

A

Major criteria = Petechial Rash, Respiratory Insufficiency, Cerebral Involvement

Minor criteria = Tachycardia, Pyrexial, Retinal Changes, Jaundice Thrombocytopaenia, Anaemia, Raised ESR, Fat macroglobulinaemia

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4
Q

When do fat embolisms develop?

A

Usually after long bone fractures or following routine orthopaedic procedures.

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5
Q

What are the clinical signs of fat embolism

A

Worsening shortness of breath, however other symptoms include confusion, drowsiness, or the development of a petechial rash

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6
Q

How do we manage a fat embolism?

A

Splinting of fracture/Fixation of long bone fracture

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7
Q

Potential complications

A

ARDS
Cerebral hypoxia

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8
Q

Managment fat embolism

A

Largely supportive. Patient may need escelation of care to HDU/ICU for ventilatory support.

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