1. -Hyper-Coagulation work up is usful in dx. of Venous thrombosis, not arterial embolization. - Embolism when an embolus migrates from one part of the body to an other blocking the site where lodges= sudden S/S -Thrombus is a blood clot formed within a blood vessel and remaining attached to its place of origin=gradual S/S - Stop Raloxifene 3 days before surgery to prevent DVT
2. 1 to 3 days after the accident
   1. Hx. of long bone or pelvic fracture CNS S/S+hypoxia+rash
      1. Dx. Fat emboli
         1. Subtopic 1
            1. Rx. I. Early surgery if needed and early moblization
3. instantly, sudden, pulslessness
   1. I. Doppler U/S, II. Angio
      1. Dx.Acute arterial occlusion
         1. Rx. embolectomy with embolus histo-pathology to FIND the source of the embolus
            1. Cardiac 20% of all cases
            2. Echo-cardiac
            3. post MI Lt. Atrial Thrombosis
            4. Atrial myxoma
            5. Peripheral
            6. angiogrophy
            7. thromboangitis obliterans
            8. Atherosclerosis-emboli
4. hours after the accident
   1. decrease blood flow to tissue , pain on passive motion, pallor, pulsless, necrosis, Rhabdomyolysis
      1. Dx. Compartment Synd.
         1. Inv. tissue pressure is more then 30 mmhg
            1. Rx.I. Remove any cast or covers, wait for an hour II. Fasciotomy with in 12 hours.