Essex and Herts Air Ambulance: a focused case series for pre-hospital practice

Pelvic fractures cause significant mortality and morbidity in major trauma patients and contribute to early deaths both pre-hospital and in-hospital. Traditional teaching that few pre-hospital interventions benefit patients with major pelvic fractures has been challenged in recent years and a number of key early interventions are now seeing many such patients survive to reach a surgeon or interventional radiologist for definitive care. We outline the case of a 38-year-old male who sustained a crush injury resulting in a severe lateral compression fracture of his pelvis with associated haemodynamic instability. Fundamental principles of pre-hospital pelvic fracture management are explained including core techniques of patient handling, splinting and packaging along with analgesic strategies and triage principles. Novel theories and interventions for haemostasis are described. The additional care that can be provided by an enhanced care team is also discussed.

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