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An assessment of pelvic binder placement at a UK major trauma centre
H Naseem1, P D Nesbitt1, D C Sprott1
1Department of Orthopaedic Surgery, Salford Royal Hospital , Salford , UK.
Insights
Pelvic binders are crucial for reducing hemorrhage in pelvic ring injuries but are often incorrectly positioned or not used at all. Improved training is needed for trauma teams to ensure correct application and patient outcomes.
Area of Science:
- Traumatology
- Orthopedic Surgery
- Emergency Medicine
Background:
- Pelvic binders are essential for managing hemorrhage associated with pelvic ring injuries.
- Correct application, typically at the level of the greater trochanters, is critical for efficacy.
- Current utilization and positioning practices in major trauma centers require evaluation.
Purpose of the Study:
- To assess the frequency of pelvic binder use in patients with pelvic ring injuries.
- To evaluate the accuracy of pelvic binder positioning in a major trauma center.
- To identify areas for improvement in the management of pelvic ring injuries.
Main Methods:
- Retrospective review of a trauma database (April 2012 - December 2016).
- Inclusion criteria: patients with pelvic binders or pelvic ring injuries (Young and Burgess classification).
- Computed tomography (CT) used for binder placement assessment.
Main Results:
- 140 patients identified; 110/140 had a binder applied.
- 50.9% of applied binders had unsatisfactory placement.
- 44.8% of patients with pelvic ring injuries did not receive a binder, including 20% with unstable injuries.
Conclusions:
- Unsatisfactory pelvic binder positioning is common.
- Pelvic binders are underutilized in patients with pelvic ring injuries.
- There is a clear need for enhanced education and training for major trauma teams regarding pelvic binder application.
Abstract:
Introduction Pelvic binders are used to reduce the haemorrhage associated with pelvic ring injuries. Application at the level of the greater trochanters is required. We assessed the frequency of their use in patients with pelvic ring injuries and their positioning in patients presenting to a single major trauma centre. Methods A retrospective review of our trauma database was performed to randomly select 1000 patients for study from April 2012 to December 2016. Patients with a pelvic binder or a pelvic ring injury defined by the Young and Burgess classification were included. Computed tomography was used to identify and measure pelvic binder placement. Results 140 patients were identified: 110/140 had a binder placed. Of the total, 54 (49.1%) patients had satisfactory placement and 56 (50.9%) had unsatisfactory placement; 30/67 (44.8%) patients with a pelvic ring injury had no binder applied, of whom 6 (20%) had an unstable injury; 9/67 patients died. Discussion This is the first study assessing pelvic binder placement in patients at a UK major trauma centre. Unsatisfactory positioning of the pelvic binder is a common problem and it was not used in a large proportion of patients with pelvic ring injuries. This demonstrates that there is a need for continuing education for teams dealing with major trauma.