Immobilizationinpelvicinjury/fracture.pptx

Immobilization in pelvic injury

1. Immobilization in Pelvic Injury

2. Pelvic Fracture/Injury High mortality 5-30% overall mortality rate Increased mortality rate to 10-42% in closed fx with hypotension 50% mortality rate in open pelvic fx Associated with multiple trauma and soft tissue injuries (GI tract, genitourinary, vascular, nerve) Usually occur in high energy trauma: Motor vehicle/motorcycle crash Pedestrian-vehicle collision Direct crush injury Fall from height

3. Pelvic Fracture/Injury D isruption of the posterior osseous ligamentous complex (i.e., sacroiliac, sacrospinous, sacrotuberous , and fibromuscular pelvic floor) D islocation of the sacroiliac joint S acral fracture S acroiliac fracture

4. Management Hemorrhage control to prevent hypovolemic shock Control achieved through: Mechanical reduction and stabilization of the pelvic ring (as soon as possible) External counter pressure Reccomended manuever Externally rotate the hemipelvis , internal rotation of the lower limbs  reducing pelvic volume C ircumferential wrapping of a sheet around the pelvis as a sling A pplying a support directly to the patient’s pelvis  splint the disrupted pelvis  reduce potential pelvic hemorrhage

5. Immobilization Techniques Pelvic Binder Pelvic Sheet (sheet wrap method) Sam Sling Vacuum Bean Bags Trauma Pelvic Orthotic Device (T-POD) Military Anti Shock Trousers

6. Pelvic Binder I nitial stabilization of choice for the immediate management of pelvic ring injuries Function/purpose: To splint the bony pelvis to reduce haemorrhage from bone ends and venous disruption. To reduce pain and movement during transfers. To provide some integrity to the pelvis when operative packing of the pelvis is necessary. To provide stabilization of the pelvis until definitive stabilization can be achieved

7. Pelvic Binder S uitable for use in the prehospital arena and emergency department. L ight and easily applied, ideally by one person. Allow access to the abdomen for laparotomy, and to the groins for angioembolization Made from soft material that will be comfortable and not induce pressure ulceration. Should not limit access to the perineum and anus for examination. Must fit various sizes of patients (including children), or different sizes be available. Should be washable or cheap enough to be disposable.

8. Military Anti Shock Trousers