To bind or not to bind: The pelvic2bind cross-sectional survey study.

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Orthopedic Surgery

Background:

• Pelvic binders are standard for suspected pelvic fractures with hemorrhage.
• Preclinical studies lack proof of principle for pelvic binder efficacy.
• Clinical experience and physician perceptions require evaluation.

Purpose of the Study:

• To evaluate clinical experience with pelvic binders in pelvic trauma.
• To assess physician perceptions of pelvic binder effectiveness.
• To identify potential discrepancies in pelvic binder application.

Main Methods:

• Survey of 271 physicians treating polytraumatized patients.
• 22-item multiple-choice questionnaire.
• Data collected at trauma surgery conferences and via professional society mailing lists.

Main Results:

• 90.4% of physicians use pelvic binders, but only 48.9% believe they improve hemodynamics.
• 95% estimate ≤50% of pelvic fractures cause significant bleeding.
• 88.5% report <50% of patients with binders have confirmed fractures.

Conclusions:

• Pelvic binders are widely accepted despite low observed efficacy for bleeding/fracture.
• A disconnect exists between routine use and evidence of benefit.
• More selective, evidence-based prehospital use of pelvic binders is recommended.