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Prehospital stabilization of pelvic dislocations: a new strap belt to provide temporary hemodynamic stabilization
B Vermeulen1, R Peter, P Hoffmeyer
1Division des Urgences Médico-Chirurgicales, Hôpitaux Universitaires de Genève.
Insights
A novel pelvic strap-belt offers rapid external compression for high-energy pelvic fractures, mitigating life-threatening bleeding. This simple device is easily applied at trauma scenes, reducing mortality risks.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Orthopedic Surgery
Background:
- High-energy pelvic fractures often cause severe intrapelvic hemorrhage, a leading cause of mortality.
- Existing external compression devices (e.g., PASG, external fixators) are often impractical for pre-hospital trauma care.
- The need for a simple, rapidly deployable pelvic stabilization device for initial trauma management is critical.
Observation:
- A new pelvic strap-belt system for external pelvic compression was developed.
- This device allows for quick (30 seconds), straightforward application at the accident scene.
- It requires minimal training and has no known complications.
Findings:
- The pelvic strap-belt effectively provides indirect tamponade to control intrapelvic bleeding.
- The system is cost-effective and highly portable for pre-hospital use.
- Initial use in 19 patients demonstrated its feasibility and ease of application.
Implications:
- This device represents a significant advancement in pre-hospital management of pelvic trauma.
- Widespread adoption could reduce mortality associated with pelvic ring disruptions.
- Further research should evaluate long-term outcomes and compare efficacy with other methods.
Abstract:
High energy pelvic fractures or dislocations are associated with a high rate of early complications, due to the associated intrapelvic organs. The high rate of early mortality is mostly due to the intrapelvic, retroperitoneal bleeding caused by the laceration of vascular structures located in the presacral area. External compression of the pelvic ring, using such devices as PASG or external fixators may prevent the intrapelvic collection of large hematomas by providing indirect tamponade. Unfortunately, these devices are either unavailable on the accident site, or the complexity of their handling is discouraging for the primary care-taker. A simple system of external pelvic compression which could be applied on the scene of trauma consisting of a pelvic strap-belt was therefore developed. The application of the device is easy, quick (30 seconds) and straightforward. Its use does not induce any known complications and requires minimal training. The cost and transportability of the system are further advantages. The system has already been used in 19 patients equipped on accident scene. Our first experiences using this device are reviewed.