Pelvic Trauma
Injuries to the pelvis can range from isolated pubic rami fractures with little debilitation, to life-threatening pelvic hemorrhage. Thus, careful attention must be paid to a patient’s vital signs and physical exam, as severe injuries can often initially be occult.
INITIAL ASSESSMENT
The “ABCs” of trauma apply.
A portable AP pelvis radiograph should be obtained in a seriously injured trauma patient.
Realize that patients with significant pelvic injuries often have injuries in other body systems.
Realize that patients with pelvic bleeding can rapidly exsanguinate.
Realize that pelvic (retroperitoneal) bleeding is not demonstrated by the FAST exam.
SPECIFIC DISORDERS
Pelvic Fractures
Present with pain in the groin (pubic rami fracture), hip (acetabular or iliac fracture), or back (sacral fracture).
The pelvis should be gently assessed for stability and pain by applying a compressive force across the hips and then downward with both hands on the anterior iliac wings.
The perineum should be carefully inspected for scrotal, labial, and suprapubic hematomas.Related posts:
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