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Practical Recommendations for Prehospital Selection of Pediatric Pelvic Circumferential Compression Devices
Insights
Pediatric pelvic fractures require specific stabilization. The Pediatric Pelvic Binder fits children under 143 cm, while the SAM Pelvic Sling is suitable for those taller, improving treatment for pediatric trauma patients.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Orthopedic Devices
Background:
- Pediatric pelvic fractures are rare but severe injuries, particularly in terror attacks.
- Current guidelines for pediatric pelvic stabilization devices are limited, relying mainly on pelvic circumference.
- Effective stabilization is crucial to reduce morbidity and mortality in pediatric trauma patients.
Purpose of the Study:
- To develop practical sizing guidelines for pediatric pelvic stabilization devices.
- To evaluate the fit of available devices based on patient height and Broselow Pediatric Emergency Tape® measurements.
- To inform clinical decision-making for Special Operations Forces (SOF) medical providers and other emergency responders.
Main Methods:
- Enrolled subjects aged 1 to 14 years.
- Collected data on height, weight, and pelvic circumference.
- Assessed the fit of the Broselow Pediatric Emergency Tape®, Pediatric Pelvic Binder®, and small SAM Pelvic Sling®.
Main Results:
- Ninety-one percent of subjects fit within the Broselow Tape scale (<143 cm).
- One hundred percent of subjects <143 cm had an appropriate fit with the Pediatric Pelvic Binder.
- Ninety-one percent of subjects >143 cm fit the small SAM Pelvic Sling.
Conclusions:
- The Pediatric Pelvic Binder is recommended for children >1 year old with suspected unstable pelvic fractures who measure <143 cm on the Broselow Tape.
- The small SAM Pelvic Sling is recommended for children taller than 143 cm.
- These findings provide evidence-based guidance for selecting appropriate pediatric pelvic stabilization devices in emergency settings.
Introduction:
Although the instances of Special Operations Forces (SOF) medical providers treating pediatric pelvic fractures are rare, such fractures are notable injuries in terror attacks and are at high risk for morbidity and mortality for the patient as well as stress for the provider. Presently, guidelines for pediatric-sized pelvic stabilization device application are limited to measured pelvic circumference. This study aims to inform more practical sizing guidelines.
Methods:
Subjects aged 1 year to 14 years were enrolled. Subject height, weight, pelvic circumference, and fit on the Broselow Pediatric Emergency Tape® (Armstrong Medical Industries), fit with the Pediatric PelvicBinder® (PelvicBinder), and fit with the small SAM Pelvic Sling® (SAM® Medical) were collected. The primary outcome was the proportion of subjects fitting each device.
Results:
Sixty-five subjects were recruited; median age was 5 years (interquartile range, 1-8 years); 40 (62%) subjects were male. Ninety-one percent of subjects fit within the scale of the Broselow Tape (height <143-cm). One hundred percent of subjects with a height <143-cm had an appropriate fit with the Pediatric PelvicBinder (95% confidence level [CI], 91.8-100%), while 91.7% of subjects with a height >143-cm fit the SAM Pelvic Sling (95%CI, 61.5-99.8%).
Conclusions:
Providers should attempt to fit the Pediatric PelvicBinder for children >1 year old with suspected unstable pelvic fracture who fall on the Broselow Tape (<143-cm). The small SAM Pelvic Sling should be used for those taller than 143-cm.
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