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Is the Application of Pelvic Binders by Pre-Hospital Care Providers justified and appropriate?

Is the Application of Pelvic Binders by Pre-Hospital Care Providers justified and appropriate?. Amit Gupta, Andrew Cook, Lee Van Rensburg. Motivation. Aim. Determine if pelvic binders are being used appropriately in the pre hospital setting. Methodology.

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Is the Application of Pelvic Binders by Pre-Hospital Care Providers justified and appropriate?

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  1. Is the Application of Pelvic Binders by Pre-Hospital Care Providers justified and appropriate? Amit Gupta, Andrew Cook, Lee Van Rensburg

  2. Motivation

  3. Aim • Determine if pelvic binders are being used appropriately in the pre hospital setting

  4. Methodology • All trauma series radiographs and computed axial tomography (CT) scans • January 2007 to December 2009 • Reviewed by: • Specialist Registrar (2nd Year) • Consultant Trauma & Orthopaedic Surgeon

  5. Methodology • Following data points collected • Presence and type of pelvic injury– classified per AO guidelines • Presence of a pelvic binder and if applicable, its position • Whether the pelvic binder was appropriate for the injury or potential to cause harm Krieg JC, Mohr M, Ellis TJ, Simpson TS, Madey SM, Bottlang M: Emergent stabilization of pelvic ring injuries by controlled circumferential compression: A clinical trial. J Trauma 2005;59:659-664

  6. Results • 76 cases 33 Pelvic injury No binder 16 Pelvic injury Binder 27 No Pelvic injury Binder

  7. Pelvic injury - 49 A-14 B-32 C-3

  8. Binder position • Correct position level of greater trochanter • 43 cases binder applied • irrespective of indication Correct position 36 Incorrect position 7

  9. Pelvic binder with injury - 16 3 Appropriate

  10. Pelvic injury, no binder - 34 5 cases would have significantly benefited from a binder

  11. Potential for injury 6 of 43 cases a binder was applied had potential for injury

  12. Posterior dislocation

  13. Fracture dislocation femoral head

  14. Cases with Neurological Symptoms with Pelvic Binder in place

  15. Bilateral Posterior Dislocation – Sciatic Neuropraxia

  16. Bilateral Posterior Dislocation with Neuropraxia and Foot Drop

  17. Conclusions Pelvic binders applied in the pre hospital phase • Placed in the correct position 36/43 (84%) • Clinical examination on scene poorly discriminates on injuries needing a binder • Binder applied 43 times • 27 (63%) No pelvic injury • 16 (37%) Pelvic injury BUT only needed in 3 (7%) • 6 (14%) Potential for harm

  18. Thank You

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