Application of pelvic binders by student paramedics: an observational cohort study
Abstract
Background:
Pelvic fractures occur in approximately 20% of all multi-system traumas and can lead to loss of life through exsanguination. Advanced Trauma Life Support (ATLS) guidelines advocate application of a pelvic binder, which is most effective when placed at the level of the greater trochanters; however, multiple studies demonstrate a high degree of misplacement.
Aims:
The aim of the current study was to assess the ability of UK student paramedics to locate the greater trochanters and optimally apply pelvic binders.
Methods:
A total of 52 student paramedics from UK universities were asked to apply a pelvic binder to a healthy volunteer using a recognised technique. The primary outcome was the location of the pelvic binder compared with an optimally applied device.
Findings:
Conclusion:
The results demonstrate a high degree of misplacement; this represents both a challenge and an opportunity for UK higher education institutions to review the manner in which pelvic binder application is taught to the next generation of prehospital practitioners.
Major trauma is a significant cause of morbidity and mortality globally and, while trauma deaths are more prevalent in less economically developed countries, death from trauma remains a significant issue in the UK. The National Audit Office (NAO) (2010) estimates that there are 20 000 cases of major trauma per annum, resulting in approximately 5400 deaths and pelvic fractures are present in 20–25% of patients who have sustained multi-system trauma (Burkhardt et al, 2014). Pelvic fractures usually result from high-energy trauma such as road traffic collisions, falls from height and crush injuries (Jain et al, 2013), and can result in exsanguination and death.
While the physical and economic impacts of major trauma are clear, the human cost is less visible and the effect of such experiences on the individual and their mental health, as well as their families, should not be underestimated.
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