see also [[Pulmonary Embolism]], [[amniotic fluid embolism]] > symptoms generally appear 12-72 hours after injury **causes** traumatic: - long bone (eg [[Femur fractures#Femoral shaft fractures|femur shaft fracture]] and pelvic fracture) - non-traumatic (rare) - diabetes, pancreatitis, burns, lipid infusions, cardiopulmonary bypass **complications** - resp → hypoxia - CNS → aloc - ARDS - vascular endothelial damage → hypotension **clinical features** *symptoms generally appear 12-72 hours after injury* 1. hypoxia 2. neurological disturbance 3. petechiae (normal platelets) CVS - unexplained tachycardia Resp - tachyponea and dysponea → progressive hypoxia CNS - agitation and confusion petechiae → later in syndrome ?due to occlusion of dermal capillaries by fat globules. NOT related to platelet dysfunction . resolves spontaneously within 5-7 days mortality 5-15% **Dx** no specific diagnostic test. exclude other things FBC - normal plts glucose CXR - usually normal ECG - sinus tachycardia CTPA - exclude large PE **Management** - ABC issues / resus / intubate as needed - early operative fracture fixation - go to ICU