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The prehospital management of pelvic fractures: initial consensus statement

Dr Scott Weingart tells it like it is

Dr Scott Weingart tells it like it is

Here is the article

The prehospital management of pelvic fractures: initial consensus statement

Key points from the statement:

  1. A pelvic binder is a treatment intervention rather than a packaging intervention and should be applied early
  2. 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
  3. No current pelvic binder has been shown to be clearly superior
  4. Adequate training is needed to apply pelvic binders properly
  5. 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
  6. 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.
  7. 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
  8. Pelvic binder should be placed next to skin for proper application – hence role of removing clothes in prehospital setting
  9. Pelvic binder should be applied prior to extrication

 

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