Effect of Early Pelvic Binder Use in Emergency

Background: We aimed to evaluate the effect of early pelvic binder use in emergency 16 management of suspected pelvic trauma, compared with the conventional stepwise approach. 17 Methods: We enrolled trauma patients with initial stabilization using a pelvic binder for suspecting 18 pelvic injury. Inclusion criteria were traumatic injury requiring a trauma team and at least one of 19 the following: loss of consciousness or Glasgow coma score (GCS) < 13; systolic blood pressure < 90 20 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury. Various 21 parameters, including gender, age, mechanism of injury, GCS, mortality, hospital stay, initial vital 22 sign, revised trauma score, injury severity score, and outcome, were assessed and compared with 23 historical controls. Results: A total of 204 patients with high-energy multiple-trauma from single 24 level I trauma center in North Taiwan were enrolled in the study from August 2013 to July 2014. 25 The two group baseline patient characteristics were all collected and compared. The trauma 26 patients with suspected pelvic fractures initially stabilized with a pelvic binder had shorter hospital 27 and ICU stays. The study group achieved statistically significantly improved survival and lower 28 mean blood transfusion volume and mortality rate although they were more severe in the trauma 29 score. Conclusions: We recommend prompt pelvic binder use for suspected pelvic injury before 30 definitive imaging is available, as a cervical spine collar is used to protect the cervical spine from 31 further injury prior to definitive identification and characterization of an injury. 32