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학습 자료 둘러보기 →Suspect FES in any patient with a long bone fracture who develops acute respiratory distress, altered mental status, and a petechial rash on the chest, axilla, or conjunctiva. Onset is typically 24 to 72 hours post-injury.
The primary injury is not just mechanical obstruction but a systemic inflammatory response to toxic free fatty acids. This leads to endothelial damage and platelet aggregation, causing the characteristic petechiae.
Do not wait for all three triad components to appear. The sudden onset of confusion and dyspnea in this setting is a critical emergency. Immediately assess oxygen saturation, prepare for respiratory support, and notify the provider. A petechial rash confirms the diagnosis but may be a late finding.
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