Pelvic fracture bleeding control: What you need to know
Todd W. Costantini, Clay Cothren Burlew, Whitney R Jenson, Roman Pfeifer, Felix Karl-Ludwig Klingebiel, Rishi Kundi, Thomas M. Scalea, Raúl Coimbra
Abstract
ABSTRACT: Significant bleeding due to pelvic fracture is associated with high mortality and must be treated promptly to optimize outcomes. The initial evaluation should focus on hemostatic resuscitation, placement of a pelvic binder, and evaluation for additional nonpelvic sources of hemorrhage. There are several options for pelvic hemorrhage control including external fixator placement, angioembolization, preperitoneal pelvic packing, and open internal iliac ligation or surgical embolization of the internal iliac artery. The specific hemorrhage control intervention selected to control pelvic bleeding must be tailored to the patient's physiologic status and local resource availability. This article discusses "What You Need to Know" to provide optimal care for patients with hemorrhage due to severe pelvic fracture.