References
Pelvic binder placement in a regional trauma centre
Abstract
Background:
Pelvic circumferential compression devices (PCCDs) are a life-saving prehospital adjunct to trauma care. Correct positioning at the level of the trochanters maximises their efficacy.
Methods:
To examine the positioning of PCCDs in a regional trauma centre in England, a retrospective analysis of patients who had experienced major trauma was carried out over a 6-month period. The primary outcome of PCCD position was assessed using computerised tomography imaging and recorded as ‘high’, ‘centred’ or ‘low’ (depending on trochanter level). Secondary outcomes, including patient demographics, mechanism, pattern, number and types of injury were also collected.
Results:
Eighty-nine patients were identified with a PCCD in situ, in whom 28 (31%) devices were positioned too high and eight (10%) too low. There was no correlation between mechanism, pattern, number or type of injury and PCCD position.
Conclusions:
Despite published evidence on PCCD position and training for personnel, many PCCDs are still poorly placed. Further education for professionals involved in PCCD application is recommended.
Pelvic ring fractures are associated with high-energy trauma, usually occurring during road traffic collisions (RTCs). Their true incidence is unknown, with estimates ranging from one in 30 to one in 80 000 of the UK population (Bircher and Giannoudis, 2004). Unstable pelvic ring injuries are associated with high mortality and morbidity.
Pelvic binders or circumferential compression devices (PCCDs), also referred to as binders, are adjuncts used mainly in prehospital care to reduce deaths from life-threatening haemorrhage occurring in pelvic injuries (Spanjersberg et al, 2009). First commercially introduced in 1999 (Vermeulen et al, 1999), they work by reducing pelvic ring displacement; this not only minimises bleeding from fractured bone ends but also decreases the effective volume of the pelvis into which haemorrhage can discharge (Spanjersberg et al, 2009). This is especially true in anteroposterior compression (APC) or ‘open book’ injuries (Bottlang et al, 2002).
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