EM Vivas · Pelvic trauma
Pelvic bleeding — the stepwise control
A clinical viva on the stepwise management of pelvic haemorrhage.
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ACEMFRCEMABEM
Prompt
Describe the stepwise approach to controlling the haemorrhage from an unstable pelvic fracture.
Interpretation
Reveal interpretationShowHide
- Pelvic binder at the greater trochanters — reduces the volume, tamponades the venous bleeding. 2. MTP — blood products 1-to-1-to-1, TXA, permissive hypotension. 3. Angiographic embolisation — the definitive treatment for the arterial bleeding. 4. External fixation — stabilises the fracture. 5. Preperitoneal pelvic packing — salvage for the too-unstable patient. 6. REBOA Zone 3 — the balloon in the infrarenal aorta for the refractory bleeding.[1]
References1ShowHide
- [1]Rossaint R, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care, 2023.PMID 36859355