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Tue Mar 10 23:48:50 GMT 2009

Dear Johan,

1. I do not know the geography in your area but if you do not have x-ray facility in the resus bay your hospital probably should be on bypass for high-energy pelvic fractures requiring a binder. If you have to look after these patients in your center (based on prehospital arrangements in your trauma system) I would suggest to get your hospital to install x-ray in the resus bay.

2. The good thing is that the pelvis has to levers (lower limbs), those are the powerful adjuncts to reduce the ring. To remove the T-pod I would suggest to bring together the knees firmly and rotate the thighs internally (this is reduces the pelvis, this is how I reduce it and keep it reduced before I start symphyseal plating or ex-fix in the OR. In this position you can open the T-pod and slide it down to mid thigh and re-tighten there if you are really worried about the pelvis.

Best Regards,

Zsolt Balogh

>>> <johan.svensson at lthalland.se> 11/03/2009 4:03 am >>>

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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Prehospital pelvic compression