References
Paramedics' perceptions and experiences of pelvic injuries in prehospital situations
Abstract
Mortality rates remain high in patients with pelvic injuries despite improvements in trauma care in recent years. Pelvic injuries are associated with patients with a high Injury Severity Score (ISS); it can therefore be difficult to distinguish whether the pelvic injury was a primary causative factor of mortality. ‘Open book’ fractures carry a mortality rate as high as 50% and clinicians should therefore have a low threshold for suspecting a pelvic injury. Paramedics should follow the latest guidance found in the UK Ambulance Service Clinical Practice Guidelines (
Pelvic injuries have increased in recent years because road traffic collisions (RTCs) have risen (Chesters, 2017). Two-thirds of pelvic injuries are sustained in RTCs, with the remainder caused by motorcycle accidents and falls from heights. Patients with fatal pelvic injuries more than likely die of exsanguination and/or associated severe injuries (Chesters, 2017).
Lee and Porter (2007) undertook a literature review to analyse the assessment and management of pelvic injuries in prehospital situations. They found that mortality rates of patients with pelvic fractures are estimated at between 7% and 19% upon their arrival at hospital, and that mortality rates of patients with ‘open book’ fractures can be as high as 50%. An open book fracture can be defined as any serious fracture that causes the pelvic ring to open like a book. This is commonly seen in anterior injuries because damage to the pubic symphysis can cause the pelvis to open (Gerecht et al, 2014).
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