The prehospital management of pelvic fractures: initial consensus statement

Mountain Rescue Casualty Care and the Undergraduate Medical Elective

“…Within the primary survey teaching, students were sometimes challenged by apparently conflicting medical needs. This was reinforced by the evidence for casualty care interventions often being based on consensus expert opinion [17][18][19] rather than empirical experimental data. Consequently, students were encouraged to appraise the risks and benefits of interventions and come to a balanced decision using suitable case studies.…”

“…Care was taken to emphasize two salient points: 1) the need to open the airway as a priority whilst giving consideration to spinal care and 2) that spinal care should not take priority over the airway. This approach was in keeping with the appropriate prehospital consensus statements [17][18][19] and helped students address uncertainty in their own clinical decision making.…”

Haemodynamics as a determinant of need for pre-hospital application of a pelvic circumferential compression device in adult trauma patients

“…In Victoria, Australia, Clinical Practice Guidelines for paramedics recommend the use of a PCCD in any suspected fracture of the pelvis [32] whereas both the National Institute for Health and Care Excellence (NICE) and the Faculty of Pre-Hospital Care (FPHC) recommend the placement of PCCDs in patients with a mechanism suggestive of pelvic fracture and signs of hypovolaemic shock [33,34]. In addition, the FPHC suggest there is a limited patient group in whom a PCCD may be considered unnecessary given normal haemodynamics, no distracting injury, and no pain on clinical assessment of the pelvis [34]; this recommendation is based on studies which have primarily focused on the use of physical examination rather than haemodynamics to detect fracture of the pelvis in alert patients [7,35].…”

Improvised first aid techniques for terrorist attacks

“…Prompt reduction and stabilisation of pelvic ring injuries is paramount in managing the substantial haemorrhage associated with these injuries. Early identification and management of a pelvic fracture at the prehospital stage is essential to reduce this mortality 13. In 30%–40% of blast injuries where the lower limbs are traumatically amputated, there will be an associated, yet hidden, pelvic fracture 14…”