UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction
  • Patients requiring a pelvic binder usually present with obvious time critical features (Quick Chart)
  • Major unstable pelvic injuries are often associated with other significant injuries that can be cumulatively life threatening
  • Substantial intra-pelvic haemorrhage is associated with increased mortality
  • Major unstable pelvic ring injuries require significant force, e.g.:
    • High velocity MVA / MBA
    • Long fall from height (+/- 3meters)
    • Significant crush-type mechanisms
Clinical Presentation
  • Significant mechanism coupled with signs of haemodynamic compromise (e.g. HR ≥100 or SBP ≤90 or GCS ≤13).
  • Other associated features may include:
    • Anatomical deformity (e.g. asymmetrical appearance)
    • Bruising
    • Wounds and haemorrhage
    • Limb shortening / external rotation (vigilance for femur injuries)
    • Paraesthesia (upper thighs, genital area)
    • Loss of power in lower limbs
  • Undifferentiated / uncontrolled hypotension in significant trauma should be a high index of suspicion for intra-pelvic haemorrhage
  • Consider distracting injuries as part of the assessment
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Pelvic binders must be applied direct to skin (or nothing more than light underwear)
  • Log rolling must be avoided where possible - less than a 15o tilt
  • Where concurrent femur fracture is suspected -prioritise pelvis treatment 
  • Ensure correct position over the greater trochanters prior to tension (i.e. not too high or low)
  • Pelvic binders are often over-tensioned - be cautious not to reduce the pelvis beyond its normal anatomical position
  • Prolonged tension can induce pressure necrosis
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • Administer pain relief
  • Consider applying cardiac monitor if trained and authorised
  • Monitor patient consistently, recording full observations every 5 - 10 minutes
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
    Critical & Extended Care (CCP, PSO)
    • As per Advanced Care (AP) guidelines
    Additional Information
    • Hypotension
    • Urogenitial injuries
    • Often associated with intra-thoracic and intra-abdominal injuries.

    References
    References
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    Head of Clinical Services

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