Pelvic binder

A pelvic binder is a device used to compress the pelvis in people with a pelvic fracture in an effort to stop bleeding.[1]

Pelvic binder
Example of using a sheet and cable ties to bind a pelvis.

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
  1. ATLS - Advanced Trauma Life Support - Student Course Manual (10 ed.). American College of Surgeons. 2018. p. 96–97. ISBN 9780996826235.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
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