Recently had a young patient with bilateral fractured femurs. Operation
delayed until 24 hours later by aneasthetists and orthopods disagreeing
over timing of operation because of other medical
problems. Result: patient suffered a cerebral fat embolism. I too am
interested about whether the timing of operation has a significant
bearing on this
Francis Andrews FFAEM
lecturer in ICM
On Sat, 28 Oct 2000, Rowley Cottingham wrote:
>I hate the term too, as I don't for a moment subscribe to the simplistic mechanism usually offered, but we seem to be
>suffering from a cluster at present even with isolated femoral #, which do not often suffer. I have been trying to analyse
>our practice in A&E which has not changed appreciably over the last couple of months, but one of the things that has
>happened is that the orthopaedic team are not operating on these patients immediately any more, but often delaying
>surgery 24 or 36 hours, leaving the patient in the Sagar or Donway splint. The surgery then gets further delayed as the
>patient is then unfit for surgery. I can't find any evidence that delay is harmful, but I am aware that early operation can be
>associated with the FES. Anyone else seeing this or is it just a statistical quirk?
>
>Best wishes,
>
>
>Rowley Cottingham
>
>[log in to unmask]
>
>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|