Pelvic sheet wrap and initial management of unstable fractures

Title : Pelvic sheet wrap and initial management of unstable fractures

Abstract:

Pelvic fractures resulting from high-energy mechanisms can be deadly. Internal bleeding from pelvic fractures can be both arterial and venous. Bleeding into the retroperitoneal space, which is large enough to hold the patient’s entire blood volume, can result in fatal hemorrhage. EMS and initial hospital recognition of unstable pelvic fractures and their stabilization, as well as an understanding of the potential intervention, can improve patient survival.

In some series, pelvic fractures have shown a 10% mortality, which has been 37% for patients greater than 60 years old. If a patient is conscious and is able to convey pelvic pain, that should raise the suspicion of a pelvic fracture. Proper and careful compression of the pelvis can help determine pain and instability. Correct placement of a pelvic sheet wrap or pelvic binder can help with pain and hypotension.  Definitive care of pelvic fractures can involve surgery and control of bleeding with interventional angiography, but the initial assessment and intervention can make an important clinical difference.

Biography:

Dr. Ramzy did undergraduate study at Northwestern University near Chicago, Illinois. He graduated from the University of Nebraska School of Medicine in 1975, and then did a General Surgery Residency. In Baltimore, Maryland, he trained in Trauma Fellowship and went on staff as a Trauma Surgeon. He also became both State EMS Director and Medical Director at the Maryland Institute for Emergency Medical Services System. He later provided surgery and critical care at the Legacy Emanuel Medical Center in Portland, Oregon, and became the Trauma Medical Director of the Level 1 Trauma Center. In his career, he published in the Journal of Trauma and made over 200 presentations in EMS and Trauma.