DOI: 10.1097/01.NURSE.0000452991.33912.1c

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PMID: 25111322

Issn Print: 0360-4039

Publication Date: 2014/09/01


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Early recognition and treatment of pelvic fractures

Joan Pirrung; Donna Mower-Wade

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Author Information: is a trauma program manager and

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Excerpt

Mr. L, 25, is involved in a motorcycle crash. The prehospital report states his vital signs as follows: temperature, 96.9° F (36.1° C); heart rate, 136 and regular; respirations, 25 breaths/min with an Spo2 of 93% on a nonrebreather mask; BP, 88/60 mm Hg; and Glasgow Coma Scale (GCS) score, 15 (patient can spontaneously open his eyes, is oriented, and obeys all commands1). Mr. L had been wearing a helmet and denies loss of consciousness. In the field he complains of severe pelvic pain and his lower extremities are externally rotated. Suspecting a pelvic fracture, emergency responders apply a pelvic binder.
After the prehospital call is accepted at the receiving facility, the trauma team assembles, reviews prehospital information, and develops a prearrival plan based on the mechanism of injury, scene assessment, and vital signs. The plan includes a focus on the potential for pelvic injury with hemorrhage into the pelvic cavity, coagulopathy, hypothermia, and immediate transport to the OR or interventional radiology (IR). The trauma nurse prepares for the administration of massive fluid and blood product resuscitation by setting up the rapid infuser and notifying the blood bank regarding the potential need for immediate type O-negative blood transfusion as well as fresh frozen plasma, platelets, and cryoprecipitate. Warming measures include increasing the room temperature, providing warm blankets, and preparing to administer warm I.V. fluids.
PELVIC FRACTURES can range from minor to complex with associated life-threatening injuries. Systematically and quickly identifying the type of pelvic fracture a patient has, along with any associated injuries, optimizes resuscitation efforts and improves long-term outcomes. This article reviews the case study of a patient who sustained a pelvic fracture and discusses his treatment along with an overview of pelvic anatomy and types of fractures.
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