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Mon Nov 3 06:37:48 GMT 2008

In the EMS service that I work for we stabilize the Pt's hips with a Vinal band and pillows between the legs. They range in size from 3-6 inches wide, and varrie in length. They are placed in the Pt's leg with a pillow between the legs. The fracture straps (vinal bands) are then placed two around both femurs and one below the knees. 
I have noticed an inprovement in patients once they have been stabilized by this method and a reduction in pain. I have had patients who stated that their pain was at a 10 on a 1-10 pain scale. 
I have seen the PASG utilized and have seen better results with the fracture straps,

~Sarah 

--- On Wed, 10/29/08, McSwain, Norman E Jr. <nmcswai at tulane.edu> wrote:

From: McSwain, Norman E Jr. <nmcswai at tulane.edu>
Subject: RE: Fwd: Pelvic fractures
To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Date: Wednesday, October 29, 2008, 1:44 PM

I guess I did not state the  question properly. I wanted to see some type of
data that the sling type device does anything to benefit the patient: reduce
blood loss, reduce pain, reduce length of stay, reduce mortality vs doing
nothing at all. The only device that I have seen data to support in the PASG in
a study done by Flint several years ago. There are other studies using PASG for
hemorrhage control that demonstrate effectiveness. Burgess sent out the
comparative study on unstable patients by Croce shows a reduction of transfusion
requirements when compared to external fixation and a reduced hospitalization.
The effectiveness was similar to the PASG

My concern is that there are no studies that demonstrate ANY altered outcome on
the patients who arrive in the ED with a simple pelvic fracture. Would they not
be just as well off if nothing was applied? If someone has data on these
patients, please identify them to me.

Norman

Norman McSwain Jr, MD FACS
Trauma Director Charity Hospital
Professor of Surgery
Tulane University School of Medicine
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On
Behalf Of William Bromberg
Sent: Wednesday, October 29, 2008 12:50 PM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Fwd: Pelvic fractures

<snip>I don't use any of them. If they don't work, why waste the
patients
money. If they work, then the manufactures should be willing to study
them. I have asked all of them if they plan good comparative studies.
Uniform answer "No" 
Typed by the thumbs of
Norman on his BlackBerry 

Norman McSwain, MD
Tulane Univ Surgery
504 988-5111 </snip>

Dr McSwain, what do you want them to compare to? Compared to each other
— they do the same thing, pick the one that's cheapest/easiest to use.
Compared to a bed sheet --They do the same thing — but they are SO
much easier (and less likely to loosen up) that many people think it's
worth it. As to comparing them to emergent ex. fix. I don't think
funding is the difficult part of that study, it's getting the orthopods
to come in (and the problems with emergent consent).

Is it that you don't believe that the concept (closing the pelvic
volume) is sound  at all or do you go right to ex. fix?

Bill Bromberg
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Fwd: Pelvic fractures