Pelvic trauma represents a serious injury and can be associated with high mortality, being the third most common cause of death in blunt trauma after head and chest injuries. The pelvis is formed by the articulation of the ilium, ischium, pubic bones, and sacrum. The pelvis can be fractured by several different mechanisms. Pelvic fractures are often associated with other major traumatic injuries; careful examination and urgent conveyance are key principles of management in these patients.
Paramedic and EMR/FR management of pelvic trauma includes: early recognition; early application of a pelvic binder; rapid conveyance; and treatment of other associated traumatic injuries.
Pelvic binding is not indicated for an isolated neck of femur (NOF) fracture (aka: hip fracture).
Paramedics and EMRs/FRs should be highly suspicious of pelvic fractures in all patients who have sustained trauma from a high-energy mechanism.
Apply a pelvic binder early – pelvic splinting should be considered a hemorrhage control intervention.
Handle the patient gently. Avoid log rolling if possible and convey using a clamshell.
Examine the abdomen and pelvis gently. Do not rock pelvis to check stability.