Device used to compress the pelvis
Pelvic binder Example of using a sheet and cable ties to bind a pelvis.
A pelvic binder is a device used to compress the pelvis in people with a pelvic fracture in an effort to stop bleeding .[1]
Uses
A pelvic binder is used to reduce haemorrhage after a pelvic fracture .[2] It is used in the majority of patients where a ring fracture to the pelvis is suspected by paramedics or physicians .[2] A pelvic binder is recommended for open book pelvic fractures .[3] It might not be useful in people with lateral compression pelvic fractures .[3]
A pelvic binder can be applied by paramedic before a patient reaches hospital , or by physicians and nurses when a patient is seen in an emergency department .[2] It should only be used short term.[1]
Complications
Complications of a pelvic binder can include skin ulceration if it is applied for too long.[1] Pelvic binders may be applied incorrectly in around 50% of patients.[2] [4]
Technique
A pelvic binder should be placed over the upper femurs , specifically the greater trochanters .[1] [2] This is the best position to reduce diastasis symphysis pubis .[5] A CT scan can be used to observe the effective placement of a pelvic binder.[2] A bed sheet may be used as part of a pelvic binder.[1]
A pelvic binder compresses pelvic structures.[2] This encourages any blood in the pelvic cavity to clot , reducing any further bleeding .[6] It also stabilises the pelvis .[2]
References
^ a b c d e ATLS - Advanced Trauma Life Support - Student Course Manual (10 ed.). American College of Surgeons. 2018. pp. 96–97. ISBN 9780996826235 .
^ a b c d e f g h Naseem H, Nesbitt PD, Sprott DC, Clayson A (February 2018). "An assessment of pelvic binder placement at a UK major trauma centre" . Annals of the Royal College of Surgeons of England . 100 (2): 101–105. doi :10.1308/rcsann.2017.0159 . PMC 5838689 . PMID 29022794 .
^ a b Walls R, Hockberger R, Gausche-Hill M (2017). Rosen's Emergency Medicine - Concepts and Clinical Practice E-Book . Elsevier Health Sciences. p. 577, 588. ISBN 978-0-323-39016-3 .
^ Vaidya R, Roth M, Zarling B, Zhang S, Walsh C, Macsuga J, Swartz J (November 2016). "Application of Circumferential Compression Device (Binder) in Pelvic Injuries: Room for Improvement" . The Western Journal of Emergency Medicine . 17 (6): 766–774. doi :10.5811/westjem.2016.7.30057 . PMC 5102606 . PMID 27833687 .
^ Bonner TJ, Eardley WG, Newell N, Masouros S, Matthews JJ, Gibb I, Clasper JC (November 2011). "Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring" . The Journal of Bone and Joint Surgery. British Volume . 93 (11): 1524–8. doi :10.1302/0301-620X.93B11.27023 . PMID 22058306 .
^ White CE, Hsu JR, Holcomb JB (October 2009). "Haemodynamically unstable pelvic fractures" . Injury . 40 (10): 1023–30. doi :10.1016/j.injury.2008.11.023 . PMID 19371871 .