Management of Pelvic Injuries EMT PDF

Management of Injuries in the Emergency and Urgent Care Setting Component 20 Management of Pelvic Injuries Management of Pelvic Injuries - Component 20 Use the key words below to create a sentence about pelvic injuries...

Management of Injuries in the Emergency and Urgent Care Setting Component 20 Management of Pelvic Injuries Management of Pelvic Injuries - Component 20 Use the key words below to create a sentence about pelvic injuries Management of Pelvic Injuries - Component 20 Pelvic Injuries Pelvic fractures represent 3-6% of all fractures in adults Occur in 20% of all polytrauma cases 75% of all pelvic injuries occur in men Haemorrhage is the cause of death in 40% pelvic trauma© patients Department of Clinical Edu 3 cation & Standards Management of Pelvic Injuries - Component 20 The Pelvis Anterior Posterior view view © Department of Clinical Edu 4 cation & Standards Management of Pelvic Injuries - Component 20 Causes of Pelvic Injuries High energy transfer e.g. RTC Fall from height Crush injury Can also be from simple falls with risk factors: Elderly Degenerative bone diseases Receiving radiotherapy © Department of Clinical Edu 5 cation & Standards Management of Pelvic Injuries - Component 20 Pelvic Injuries - RTC Any significant door intrusion into the passenger space should give cause for concern, as should a dented petrol tank on a motor bike. ©Department of Clinical Education & Standards Common Fracture sites ©Department of Clinical Edu cation & Standards  Complications Increased pelvic volume due to fracture allows for increased haemorrhage Vascular injuries leading to haemorrhage Urogenital injuries – bladder rupture in 10% Common to have other injuries to manage e.g. intra-thoracic/intra-abdominal ©Department of Clinical Edu cation & Standards  Signs & Symptoms Mechanism Bruising Bleeding from the patient’s rectum, vagina or urethra Deformity Swelling Shortening of lower limb Pain over the hips, groin or lower back Hypovolemic shock Altered sensation in one leg ©Department of Clinical Edu cation & Standards Management of Pelvic Injuries What does the JRCALC Guideline say? ©Department of Clinical Edu cation & Standards  Management Time critical – DRABC & Splint Consider C-spine when managing airway Control catastrophic haemorrhage High flow O2 Pelvic Splint – immobilise knees and ankles as well Consider Paramedic assistance Pain relief Smooth rapid removal, consider MTC Full observations ©Department of Clinical Edu cation & Standards  Management Avoid repeated examinations/movements Never ‘spring’ the pelvis – this may dislodge blood clots may exacerbate injury Once the pelvic splint has been placed – do not remove it ©Department of Clinical Edu cation & Standards ©Department of Clinical Edu cation & Standards  Pelvic Splint Apply the pelvic splint in conjunction with the scoop stretcher to avoid rolling the patient twice The bright yellow side (fuzzy material) of the splint should also be on the outside of the splint The black side of the material should be on the inside of the splint next to the patient’s skin. ©Department of Clinical Education & Standards  Pelvic Splint The middle of splint should sit at the level of the greater trochanter - The bony prominence on the lateral aspect hip. A common error is to apply the splint over the iliac crest. This is too high. ©Department of Clinical Edu cation & Standards  Pelvic Splint The wide yellow pelvis band should be slide under the patient The patient should be rolled no more than 10 degrees, and the wide yellow pelvis band is placed in a ‘L’ shape and passed under the patient. ©Department of Clinical Edu cation & Standards ©Department of Clinical Edu cation & Standards ©Department of Clinical Edu cation & Standards ©Department of Clinical Edu cation & Standards  Pelvic Splint With the help of an assistant on the other side of the patient, pull the rectangular tabs up and away from the patient. This will bring the pelvis to an anatomically normal shape and size. Take care not to over compress the pelvis. The rectangular tabs should then be ©Department securedof to Clinical Edu the wide yellowcation band. & Standards  Pelvic Splint If after application of the splint the feet remain externally rotated, secure the feet with a figure of 8 using a broad fold triangular bandage The pelvic splint can be used in conjunction with the Kendrick Traction Splint if there is a concurrent fractured femur. The pelvic splint should be applied first then the traction splint ©Department of Clinical Education & Standards  Pelvic Splint As the pelvic splint is cut to size, it can fit a massive range of patients from paediatric to bariatrics It is a single use device ©Department of Clinical Edu cation & Standards  Summary Pelvic injuries can lead to fatal haemorrhage Minimise movement when treating pelvic injuries and limit log roll to 10 degrees Pelvic injuries require immediate splinting and transport to MTC Pelvic splints are single-use only and once applied, will not be removed by ambulance clinicians. ©Department of Clinical Edu cation & Standards Any Questions? ©Department of Clinical Edu cation & Standards