Prehospital pelvic compression

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Johan

Good reason to change practice - they should NOT be used pre-hospital: The
pelvic binder is only useful for open-book fractures (AP compression
type), more for patient support than anything else (I agree with Norman's
comments).

Good practice of ATLS is to do an EXPOSURE with ENVIRONMENTAL control -
neither is possible with the binder. If they want to use something, the
Pelvigrip type device, with velcro straps for easy removal/adjustment is a
better option. Also re-usable (made of neoprene)

How fast do you get your trauma-CT. If less than 30 minutes - fine,
otherwise get the pelvic mobile film in the ER.

Regards
Tim

Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer University of KwaZulu-Natal Dept Surgery
Deputy Director - IALCH Trauma Service
Durban - South Africa
>
> Hello!
> I have a question to all of you regarding the use of prehospital pelvic
> binders. I work at a small hospital where we dont have access to x-ray of
> the pelvis in the traumaroom. Currently the prehospital personel applies
> the TPOD (pelvic binder) in the prehospital setting whenever they suspects
> a pelvic fracture. The TPOD is often placed before removing the patients
> cloths. This approach interferes the examination of the patient in the
> traumaroom because when the pelvic divice is applied prehospital every one
> is afraid of removing it with the fear of bleeding. Since we dont have
> acces to plain x-ray in the traumaroom we often leave the TPOD until the
> trauma-ct is done and we have  pictures. The tpod also makes it difficult
> to remove the patients clothes and sometimes makes it impossible to make a
> good examination of the lower back, perineum/rectum. How would yo approach
> this matter?
>
> Johan
>
>
>
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