
Here is the article
The prehospital management of pelvic fractures: initial consensus statement
Key points from the statement:
- A pelvic binder is a treatment intervention rather than a packaging intervention and should be applied early
- Some trauma patients do not need a pelvic binder – Normal GCS and haemodynamically stable are essential requirements ! Pelvic springing has poor sensitivity and specificity and is not recommended
- No current pelvic binder has been shown to be clearly superior
- Adequate training is needed to apply pelvic binders properly
- Associated femoral fractures should be reduced – if haemodynamically stable, femoral fractures should be reduced and traction splinted with a device that minimises disruption of the pelvis. If haemodynamically unstable, legs should be bound in position found and pelvic splint applied
- Patients should not be log rolled nor transported on spinal board – routine log rolling should be avoided and only has role in positioning for airway access.
- Pelvic binders carry risk of low pressure skin necrosis – low blood pressure may increase risk of this and providers needs to be constantly aware of risk
- Pelvic binder should be placed next to skin for proper application – hence role of removing clothes in prehospital setting
- Pelvic binder should be applied prior to extrication