KEY POINTS:

• Presentation 24-72h post-injury - risk during major trauma and surgery (esp long bones)
• Pathophysiology:
1. Fat from marrow into lungs = pulmonary hypertension, RV strain, hypoxia
2. SIRS from fatty acids = myocardial depression, ARDS, DIC
• Prevention = early immobilisation/reduction and operative management
• Dx of exclusion but classic triad of GURDS = confusion, respiratory distress and petechiae
• Petechiae only present in 50% but pathognomonic 
• Mx = exclude other Dx (PE, anaphylaxis) --> treat fracture (no cement)
• A) ETT (req in 40%)
• B) FiO2 1.0, ARDS-ventilation
• C) fluids, pressors, inotropes, coags correct (DIC)
• D/E) normal sugar/temp
• ICU post-op, resolves <7 days