Does Application Position of the T-POD Affect Stability of Pelvic Fractures?

Prasarn, Mark L.; Small, John; Conrad, Bryan P.; Horodyski, Nicole; Horodyski, MaryBeth; Rechtine, Glenn R.

doi:10.1097/bot.0b013e31826913d6

Cited by 21 publications

(19 citation statements)

References 33 publications

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“…One reason for this might be that Sweden is a country with some sparsely populated areas with sometime long distances to larger hospitals. Primary care of high-energy patients is then sometimes conducted at these smaller units, and transport to the definitive level of care happens only after initial physiological stabilization of these patients.It is recommended that a PCCD is applied at the level of greater trochanters [ 4 , 12 , 13 ]. We found that 83 % of the doctors in our study defined the greater trochanters as the level of choice for application of a PCCD.…”

Section: Discussionmentioning

confidence: 99%

Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey

Bakhshayesh

Heljesten

Weidenhielm

et al. 2018

BEAT

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Objective:To assess availability, experience, and knowledge about the Pelvic Circumferential Compression Device (PCCD) in Sweden.Methods: A telephone interview with the current on-call trauma doctors at all trauma units in Sweden was conducted. After a short presentation and oral consent, the doctors were asked to answer four short questions. We asked the doctors to answer whether they knew if they had PCCDs available in their emergency room, how many times had they applied a PCCD, which is the correct level of application for a PCCD, and if a PCCD can stop arterial bleeding. Results:The on-call trauma doctors at the nine University hospitals, twenty-two General hospitals and twenty-one District General hospitals, with response rate of 100%, were interviewed. Availability of PCCD was 85 % and there was no difference between hospital types (p=0.546). In all hospitals 29/52 (56%) of those interviewed had used a PCCD at least once. There were significantly more doctors that had used a PCCD at least once in the University hospitals (8/9), compared to General hospitals (13/22) and District General hospitals (8/21) (p=0.034). A total of 43/52 (83 %) doctors defined the greater trochanters as the correct level of application for a PCCD. No difference was found when comparing hospitals (p=0.208). Only 22/52 (42 %) of doctors answered that a PCCD could not stop an arterial bleeding. No difference was found between hospitals (p=0.665)Conclusion:Less than half of the doctors knew that a PCCD cannot stop arterial bleeding, while the majority knew the correct level of application of a PCCD.

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Section: Discussionmentioning

confidence: 99%

Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey

Bakhshayesh

Heljesten

Weidenhielm

et al. 2018

BEAT

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“…The same authors group conducted further analysis comparing the position of T-POD application at the level of the greater trochanters and the anterior superior iliac spine. In this yet another simulated unstable cadaveric fractures, motion analysis demonstrated better stability in sagittal, coronal and axial planes when the T-POD is applied over the greater trochanters as per manufacturers recommendations [ 22 ].…”

Section: Mechanical Effectsmentioning

confidence: 99%

Effectiveness of non invasive external pelvic compression: a systematic review of the literature

Bakhshayesh

Boutefnouchet

Tötterman

2016

Scand J Trauma Resusc Emerg Med

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IntroductionPelvic fractures might carry a significant risk of bleeding. A wide variety of pelvic binders together with pelvic sheets are available and offer an adjunct to the initial management of poly-trauma patients with pelvic injuries. These devices are collectively referred to as pelvic circumferential compression devices (PCCDs). The aim of this study was to review the literature for evidence pertinent to the efficacy and safety of PCCDs.MethodsUsing the PRISMA guidelines a systematic search on PubMed, Web of Science, CINAHL, Embase and Scopus was carried out. Articles included were in English language and published between 1999 and 2015. Studies included were appraised with narrative data synthesis.ResultsSeven articles addressed mechanical properties of non-invasive external mechanical devices, six articles focused on physiological aspects, and three studies evaluated the pressure characteristics of these devices. We found 4 case reports regarding adverse effects. None of the studies identified addressed the cost effectiveness or pain relief issues related to the use of PCCDs.ConclusionsBased on available literature, PCCDs are widely used in the initial management of patients with suspected pelvic bleeding. There is evidence to suggest that external compression reduces disrupted pelvic rings. There are some complications reported following application of PCCDs. Hemorrhagic source and physiological effectiveness of PCCDs needs to be addressed in future studies. In the meantime judicious application of PCCDs will continue to be recommended.

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“…2,3 Early pelvic stabilization is postulated to help prevent exsanguination by both decreasing pelvic volume, limiting interfragmentary motion, and thus permitting stable clot formation. [4][5][6][7][8][9][10][11][12][13][14][15] Both commercial binders and traditional sheeting techniques seem to be effective at reducing pelvic volume. [4][5][6][7][8][9][10][11][12][13][14][15] Both commercial binders and traditional sheeting techniques seem to be effective at reducing pelvic volume.…”

Section: Introductionmentioning

confidence: 99%

Effect of Pelvic Binder Placement on OTA Classification of Pelvic Ring Injuries Using Computed Tomography. Does It Mask the Injury?

Swartz

Vaidya

Hudson

et al. 2016

Journal of Orthopaedic Trauma

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Does Application Position of the T-POD Affect Stability of Pelvic Fractures?

Abstract: We advocate the placement of pelvic binder devices at the level of the greater trochanters for improved control of the fracture in an unstable pelvic injury. This may result in improved control of hemorrhage, better access to the abdomen, and greater patient comfort.

Cited by 21 publications

References 33 publications

Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey

Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey

Effectiveness of non invasive external pelvic compression: a systematic review of the literature

Effect of Pelvic Binder Placement on OTA Classification of Pelvic Ring Injuries Using Computed Tomography. Does It Mask the Injury?

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