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Fat Embolism Syndrome

Classically 24–72 h after long‑bone/pelvic fractures or IM reaming; triad: hypoxemia, neurological signs, petechiae. Diagnosis is clinical; supported by Gurd’s criteria (1 major + 4 minor) or Schonfeld score (>5). ABG hypoxemia, CXR fluffy infiltrates; brain MRI 'starfield' pattern on DWI. Prevention: early stabilization of long bone fractures; careful reaming/venting. Management: supportive (oxygen/PEEP, fluids), avoid overload; steroids controversial.