![]() ![]() Log rolling should be avoided, and straight lifts are recommended in the initial period. The pelvis should not be mechanically stressed as this will risk destabilising clot formation. Pelvic fractures are seldom isolated injuries and therefore further management may be dictated by the various injuries sustained.ĭiagnosing pelvic injury in the context of major trauma should be determined by mechanism of injury, clinical examination, and radiological evidence. 6 The correct application of the pelvic binder should be confirmed, and skeletal traction should be considered where vertical instability is present. Many prehospital retrieval protocols include the use of a pelvic binder with suspected pelvic fractures. Initial management should follow advanced trauma life support protocols to help identify and manage life-threatening injuries. The majority of pelvic fractures present to major trauma centres unless the ambulance team divert to the nearest hospital because of cardiac arrest on presentation or in transit. Initial management of the presenting patient It also outlines the function of the pelvis, relevant anatomy, and classification of pelvic injuries. This article aims to detail the anaesthetic management of these patients through their hospital journey from presentation to postoperative care. The key priorities in the management of high-energy pelvic fractures are patient resuscitation, fracture stabilisation, and definitive fixation. 3 The long-term implications include physical and mental health problems, which lead to a substantially reduced quality of life for survivors and significant socioeconomic implications for society. Associated traumatic brain injuries are common and account for approximately 20% of early deaths. Haemorrhage is the leading cause of death in these patients with bleeding from additional injuries being equally as likely to cause death as pelvic haemorrhage. 1, 2 Increasing age, open pelvic fractures, and severe head, chest, or intra-abdominal injury also increase the risk of mortality. The overall mortality rate for all types of pelvic fractures ranges from 5% to 15% and increases considerably in those who are haemodynamically unstable on presentation. Typical mechanisms of injury include motor vehicle accidents, pedestrians struck by a motor vehicle, falls from height, and crush injuries. The management of patients with traumatic pelvic fractures remains a significant challenge requiring rapid evaluation and intervention from a multidisciplinary team. Early initiation of thromboprophylaxis and surgical intervention helps reduce morbidity from venous thromboembolism. ![]()
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