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Fat embolism syndrome (FES) is a multiple organ disorder that can appear after pelvic and long bone fractures. The most common clinical finding is hypoxia, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, polypnea, and tachycardia. We present a mild FES case on a 32-year-old man with no medical history admitted for an orthopedic procedure, following both tibia and fibulae fractures. Thirty hours postoperatively, he developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated in a dedicated COVID-19 ward and three negative RT-PCR SARS-CoV-2 tests, he returned to continue supportive treatment in the orthopedic intensive care ward. His evolution was favorable with discharge at ten days, without sequelae. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process. Added to the variety of preexisting respiratory diseases and disorders, the COVID-19 infection, with its symptomatology so similar to multiple other pulmonary diseases, must not cloud our clinical judgement.

Background Previous studies have shown that the public perception of anaesthesiologists' duties regarding perioperative management lacks a good understanding. The aim of this study was to assess the public perception of the anaesthesiologist's role before, during and after surgery, in Romania. Method The prospective cross-sectional study was undertaken between January 2015 and August 2016. A questionnaire that comprised 23 questions was uploaded on Google at https://docs.google.com/forms/d/1KxC8jSYydhEu3pn0Hr0LHEsuCEQLSEHQqUo_HzrHuw8/viewform. The link was forwarded on-line randomly (mail, social media). The questions were structured based on current literature. Inclusion criteria were people aged >15 years and not directly related to any medical activity. The answers were anonymously registered, in real time, in an Excel format, used later to process the statistics. Results 1153 people completed the questionnaire, 61% female and 39% male, 80.8% being from the urban area and 19.2% from the countryside. 62.7% were hospitalized in the past, and 49.8% had undergone at least one surgery. From the questioned group 65.2% had graduated university, and 64.3% were aged between 20 and 40 years. A majority of 1089 respondents (94.6%) knew that the anaesthesiologist was responsible for providing anaesthesia in the operating room. 26.6% considered that the surgeon and the anaesthesiologist played different roles in OR, but 54.4% understood that there is a collaboration between them during surgery. Only 36.2% were aware that the anaesthesiologist replaces blood losses and provides patients hemodynamic stability and proper oxygenation during surgery. 54.6% believe that the surgeon decides upon the postoperative pain management and only 32% know the anaesthesiologist is the physician in charge of intensive care patients. 79.5% of respondents are willing to receive from their anaesthesiologist detailed information, regarding anaesthesia and postoperative care, before surgery, and consider that more publicity should be made regarding this profession. Conclusion The public perception of the anaesthesiologist's role in Romania is inaccurate in spite of the fact that a large group in our study comprised highly educated people living in urban areas. We consider that further strengthening of the anaesthesiologist/patient relationship and an increased media exposure of our specialty would help to improve its social perception.