Is the Application of Pelvic Binders by Pre-Hospital Care by lk35118


									Amit Gupta, Andrew Cook, Lee Van Rensburg
   Determine if pelvic binders are being used
    appropriately in the pre hospital setting
   All trauma series radiographs and computed
    axial tomography (CT) scans
       January 2007 to December 2009
   Reviewed by:
       Specialist Registrar (2nd Year)
       Consultant Trauma & Orthopaedic Surgeon
        Following data points collected
             Presence and type of pelvic injury– classified per
              AO guidelines
             Presence of a pelvic binder and if applicable, its
             Whether the pelvic binder was appropriate for the
              injury or potential to cause harm

Krieg JC, Mohr M, Ellis TJ, Simpson TS, Madey SM, Bottlang M: Emergent stabilization of pelvic ring
injuries by controlled circumferential compression: A clinical trial. J Trauma 2005;59:659-664
   76 cases

     33              16               27
Pelvic injury   Pelvic injury   No Pelvic injury
 No binder        Binder            Binder
A-14         B-32

         Correct position level of greater trochanter
         43 cases binder applied
             irrespective of indication

Correct position                           Incorrect position
      36                                           7
                    5 cases
would have significantly benefited from a binder
6 of 43 cases a binder was applied had potential for injury
Pelvic binders applied in the pre hospital phase
 Placed in the correct position 36/43 (84%)

 Clinical examination on scene poorly discriminates
  on injuries needing a binder
     Binder applied 43 times
       27 (63%) No pelvic injury
       16 (37%) Pelvic injury BUT only needed in 3 (7%)
       6 (14%) Potential for harm

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