Immediate application of improvised pelvic binder as first step in extended resuscitation from life-threatening hypovolaemic shock in conscious patients with unstable pelvic injuries

Nunn, Timothy; Cosker, T.D.A.; Bose, Deepa; Pallister, Ian

doi:10.1016/j.injury.2006.06.026

Cited by 49 publications

(29 citation statements)

References 8 publications

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“…Staff working in trusts that did not have these available indicated they used bed sheets secured with cable ties, tape or artery clips in order to provide pelvic compression and stability. Whereas this technique has been well described [13], it does not allow the applied reduction force to be controlled to a predetermined level [14] and is less effective in reducing symphyseal diastasis in open-book injuries when compared with pelvic binders [15]. Also, a narrow sheet may increase the risk of developing pressure sores when compared with a commercially available binder.…”

Section: Discussionmentioning

confidence: 99%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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Purpose Major pelvic injuries resulting from high-energy trauma require emergency hospital treatment, and part of the initial management includes mechanical stabilisation of the pelvis. Controversies include binder position, use in lateral compression injuries and application during radiological assessment. We present the results of a survey of both emergency department and orthopaedic specialties. Methods A telephone survey of all 144 trauma units in the UK accepting adult pelvic trauma patients was carried out in July 2012. The duty registrar for the emergency and orthopaedic departments was contacted and asked to complete a questionnaire. Results A response rate of 100 % was achieved. Pelvic binders were available for use in approximately three quarters of the trauma units surveyed. Eight-five emergency department (59 %) and 79 orthopaedic (54.9 %) registrars had been given training on pelvic binder application. Fiftysix emergency department (38.9 %) and 114 orthopaedic (79.1 %) registrars identified the level of the greater trochanters as the most suitable position for the binder. Forty-five emergency department (31.3 %) and 58 orthopaedic (40.3 %) registrars used pelvic binders in suspected lateral compression injuries. One hundred and twenty-six emergency department (87.5 %) and 113 orthopaedic (78.5 %) registrars would not release the binder during radiological assessment of the pelvis in a haemodynamically stable patient.

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Section: Discussionmentioning

confidence: 99%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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“…Pelvic circumferential compression is used in the prehospital phase and contributes to early non-invasive hemodynamical stabilization within the 'Golden hour' [4,5]. Advanced Trauma Life Support (ATLS) guidelines advise the use of a PCCD when an unstable pelvic fracture is suspected or diagnosed as a technique to stabilize the patient hemodynamically by reducing blood loss.…”

Section: Introductionmentioning

confidence: 99%

Measurements of the Exerted Pressure by Pelvic Circumferential Compression Devices

vanLieshout¹,

Goossens²,

Riel³

et al. 2010

TOORTHJ

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Abstract:Background: Data on the efficacy and safety of non-invasive Pelvic Circumferential Compression Devices (PCCDs) is limited. Tissue damage may occur if a continuous pressure on the skin exceeding 9.3 kPa is sustained for more than two or three hours. The aim of this study was to gain insight into the pressure build-up at the interface, by measuring the PCCD-induced pressure when applying pulling forces to three different PCCDs (Pelvic Binder ® , SAMSling ® and T-POD ® ) in a simplified model. Methods:The resulting exerted pressures were measured at four 'anatomical' locations (right, left, posterior and anterior) in a model using a pressure measurement system consisting of pressure cuffs. Results:The exerted pressure varied substantially between the locations as well as between the PCCDs. Maximum pressures ranged from 18.9-23.3 kPa and from 19.2-27.5 kPa at the right location and left location, respectively. Pressures at the posterior location stayed below 18 kPa. At the anterior location pressures varied markedly between the different PCCDs. Conclusion:The circumferential compression by the different PCCDs showed high pressures measured at the four locations using a simplified model. Difference in design and functional characteristics of the PCCDs resulted in different pressure build-up at the four locations. When following the manufacturer's instructions, the exerted pressure of all three PCCDs tested exceeded the tissue damaging level (9.3 kPa). In case of prolonged use in a clinical situation this might put patients at risk for developing tissue damage.

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“…11 The available pelvic binders studies show advantages of pelvic binders in bleeding control. 16,17 Manipulation of the fracture was performed during the necropsy to demonstrate and prove how a simple sheet contention can promote stabilization of the pelvic ring by closing the sacroiliac joints in open book fractures -allowing an early control of lifethreatening bleeding on-site (Fig. 3/video).…”

Section: Discussionmentioning

confidence: 99%

The importance of pelvic ring stabilization as a life-saving measure in pre-hospital – A case report commented by autopsy

Durão

Alves

Barros

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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Keywords:Unstable pelvic ring Open book pelvic fracture Hemorrhagic shock A B S T R A C T Hip fractures with unstable pelvic ring have great morbidity and mortality rates. These fractures result from high energy trauma such as falls from heights, road accidents and collapsing structures or other similar mechanisms of action. We report the case of a 63 years old man, construction worker, who stood inside a ditch during a wall construction when he was surprised by this collapse, which resulted in direct trauma to the right thigh and pelvis. The autopsy revealed diaphysis fracture of the right femur with an open book pelvic fracture with severe hemorrhagic infiltration and hematoma of the pelvic muscles without arterial injury. Bone bleeding and the vascular damage associated with disruption of the sacroiliac ligaments promote a very significant bleeding. Simple maneuvers such as sheet circumferential compression to promote pelvic ring closure are effective on stabilizing and closure of the sacroiliac joint. Hip manipulation of the fracture was performed during the necropsy to demonstrate and prove how a simple sheet contention can promote stabilization of the pelvic ring by closing the sacroiliac joints in open book fractures.

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Immediate application of improvised pelvic binder as first step in extended resuscitation from life-threatening hypovolaemic shock in conscious patients with unstable pelvic injuries

Cited by 49 publications

References 8 publications

A national survey of United Kingdom trauma units on the use of pelvic binders

A national survey of United Kingdom trauma units on the use of pelvic binders

Measurements of the Exerted Pressure by Pelvic Circumferential Compression Devices

The importance of pelvic ring stabilization as a life-saving measure in pre-hospital – A case report commented by autopsy

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