Tamingthesru
Who Gets a Pelvic Binder? Lessons from the #HEMS #FOAMed World
In our most recent post in the Air Care & Mobile Care Online Flight Physician Orientation, we talked about pelvic binding devices. As we noted, there's generally a paucity of evidence for or against the use of a pelvic binding device in blunt trauma patients. There are no hard and fast indications for the use of these devices. Whenever there is a lack of evidence for a particular treatment, we find ourselves looking to experts in the field for their experience and practice patterns. To that end, I asked some of of the #HEMS #FOAMed community to weigh in on the question and tell us their practice pattern
Application of Pelvic Binders
As we mentioned in the podcast that accompanied our most recent post, an injury that is critical to identify in blunt trauma yet easy to miss or forget is pelvic fractures and pelvic trauma. Significant injuries occurring to the pelvic ring usually involved high mechanisms of injury such as high speed MVCs, motorcycle crashes, pedestrian struck, and falls from significant height. Pelvic fractures can be associated with a significant amount of bleeding, hypotension, and increased mortality. Mortality for all trauma patients with pelvic trauma ranges from 5-30%. If there is associated hypotension, mortality rises to 10-42%
Evaluating Blunt Trauma Patients
A quick and thorough evaluation of patients with traumatic injuries is extremely important. The ideal approach is regimented, practiced, expeditious, and flexible to the environment in which it is performed. Advanced Trauma Life Support (ATLS) courses do a great job of teaching the guiding principles to the approach to the trauma patient. However, while it is relatively simple to become facile with the exam of victims of trauma in the (relatively) controlled setting of the trauma bay, it can be especially challenging to examine the same patient in the field.