Pubic Diastasis Power Point

1. Pelvis Case #4

2. H&P 27 yo male presents after a high speed MVC to the trauma bay. EMS reports significant damage to the car. The patients is able to complain of severe abdominal and pelvic pain. PE P 115 BP101/62 RR22 Gen: Appears very uncomfortable. Pale. Abd : TTP particularly in the lower half of the abdomem . Pelvis feels unstable

3. Pubic Diastasis

4. ACLS, fluid resuscitation, pain control Apply either a pelvic binder or use a bed sheet to stabilize the pelvis Avoid excessive movement of the pelvis Eval for other injuries ED Managment

5. This is a high impact injury often associated with other injuries Pelvic hematoma’s can form causing life threatening hemorrhage. These can be treated with embolization. Urethral injuries are also often associated with this injury. Foley should not be placed until urethral injury is ruled out with RUG. Pearls

6. Mechem , C et al. “Pelvic Fracture in Emergency Medicine” . Emedicine.com . 5/2010. Thornton, D et al. “Pelvic Ring Fracture Imaging” . Emedicine.com 5/2011 Tininalli , J et al. “Emergency Medicine: A Comprehensive Study Guide”. 6 th ed. 2003 References