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Pelvic Fractures – Anatomy of the Bleed

Rob Orman, MD and Chris Hicks, MD
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18:54
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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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03:42

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EM:RAP 2017 February Written Summary 971 KB - PDF

Part one of trauma team leader Chris Hicks’ primer on managing severe pelvic fractures.

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Daniel J. C., M.D. -

Great summary. Wished we had more specific information on empiric initial volume and or blood product recommendation in obvious pelvic fractures. And hey how about the old MAST Trousers? Dead and buried?

Chris H., MD -

It might be coming in Part II -- but my pelvic fracture "test dose" is 2U PRBC, pelvic binder and TXA. If the patient remains unstable after this, one of two things is possible: a) This is an arterial bleed, and the patient needs angio/OR ASAP, or b) There is another hemodynamically significant injury present that hasn't been addressed yet. So if the patient remains HD unwell after that "test dose" I am doing two things: activating our massive transfusion protocol (if I haven't already) and mobilizing angio and/or OR resources.

MAST trousers are dead -- but wait another 5 years and they'll be back in vogue! Medicine just seems to work like that.

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Bad Bleeds in the Brain and Pelvis Full episode audio for MD edition 243:12 min - 339 MB - M4AEM:RAP 2017 February Australian Edition Australian 17:35 min - 24 MB - MP3EM:RAP 2017 February Canadian Edition Canadian 18:09 min - 25 MB - MP3EM:RAP 2017 February Spanish Edition Español 81:17 min - 112 MB - MP3EM:RAP 2017 February German Edition Deutsche 68:14 min - 78 MB - MP3EM:RAP 2017 February French Edition Français 28:00 min - 39 MB - MP3EM:RAP 2017 February Board Review Answers 191 KB - PDFEM:RAP 2017 February Board Review Questions 184 KB - PDFEM:RAP 2017 February Separate MP3 Files 323 MB - ZIPEM:RAP 2017 February Spanish Written Summary 1 MB - PDFEM:RAP 2017 February Written Summary 971 KB - PDF

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