Editing Pelvic trauma (section)

== Primary interventions ==

* X-ray pelvis in trauma bay if any suspicion bleeding
* Indications for pelvic binder: (examine perineum etc first)
** Gross displacement of pelvis
** Gross asymmetry of pelvic bones
** Vertical shifting of the ilium on one side
** Open book deformity of pelvis
** Probably not useful in LC1 or LC2 injuries
* Binder application
** Don't apply if going straight to OT
** If bleeding/open pelvic wounds, rapidly irrigate and pack them prior to binder
** Bring heels together and internally rotate legs
** '''Centre over GTs''' so compressive force is applied inward through femoral heads
** Avoid wrinkles in sheets or binders
** Adequate compression - often need 2 to 3 people
** Leave for up to 24 hours, and only longer if necessary for life
* External pelvic fixation
** Good for venous bleeding, may not work as well for arterial
* Antibiotics if open wounds - cefazolin for simple wounds, ceftriaxone/metronidazole if large degloving wounds or bowel injuries

=== Need to check on admission in pelvic fracture ===

* Associated injuries:
** Bladder/urethral
** Vaginal tears
** Rectum
* Perineum for open fractures/fragment penetration
* Theoretically should do DRE
* Blood at urethral meatus?
* Limb shortening
* Flexion/extension of all joints
* Check all lumbar and sacral roots
* Rectal tone and perianal sensation