The pre-hospital management of pelvic fractures: initial consensus statement
Serious pelvic injuries are associated with a high mortality rate (Papakostidis and Giannoudis, 2009; Chesser et al, 2012), which has remained persistently high even with advances in hospital care. Hypovolaemia is often a significant contributing factor to these deaths (Lee and Porter, 2007; Papakostidis and Giannoudis, 2009). If haemorrhage from pelvic injuries could be controlled or reduced in the pre-hospital environment, then survival rates might increase.
Improved mortality has been seen with catastrophic haemorrhage from limb injuries after the introduction of the battlefield tourniquet and topical haemostatic dressings (D'Alleyrand et al, 2010). However, compared with bleeding from pelvic injuries, external haemorrhage is simple to recognise and the success of intervention easier to observe.
Pelvic binding devices provide a simple alternative to surgical fixators. These devices can be applied in the pre-hospital environment, potentially allowing control of unseen major haemorrhage (Chesser et al, 2012). This article reports the finding of a consensus meeting on the pre-hospital management of pelvic injuries held in March 2012 and examines the evidence associated with pelvic binding devices and their application.
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