Anaesthesia for extremity injuries
*notes taken from local master student program Overview · Extremity injuries can be life-threatening because of associated vascular injuries and secondary infectious complications. Problems Hemorrhage · Vascular injuries can lead to massive hemorrhage and threaten extremity viability. · For example, a femoral fracture can be associated with 2–3 units of occult blood loss, and closed pelvic fractures can cause even more occult blood loss resulting in hypovolemic shock. · Delay of treatment or indiscriminate positioning can worsen dislocations and further compromise neurovascular bundles. Fat emboli · Fat emboli are associated with pelvic and long-bone fractures and may cause pulmonary insufficiency, dysrhythmias, skin petechiae, and mental deterioration within 1–3 days after the traumatic event (see Chapter 40). · The laboratory diagnosis of fat embolism depends on elevation of serum lipase, fat in the urine, and thro...
