Bilateral Femoral Fractures with Fat Embolism Syndrome

You have commenced your shift this morning as the in-charge consultant anaesthetist in a regional hospital where you are also responsible for the intensive care unit (ICU). In the ICU, there is a 40-year-old man with isolated bilateral femoral fractures who was admitted 20 hours ago and has been booked for surgery later today. He is otherwise well with no co-morbidities or other injuries. You have been asked to review the patient as his pain is poorly controlled despite having been prescribed an intravenous morphine patient-controlled analgesia regimen. Your nursing staff also tell you that the patient is becoming increasingly confused.