Amit Gupta, Andrew Cook, Lee Van Rensburg

 Determine if pelvic binders are being used appropriately in the pre hospital setting

 All trauma series radiographs and computed axial tomography (CT) scans  January 2007 to December 2009  Reviewed by:  Specialist Registrar (2 nd Year)  Consultant Trauma & Orthopaedic Surgeon

 Following data points collected  Presence and type of pelvic injury– classified per AO guidelines  Presence of a pelvic binder and if applicable, its position  Whether the pelvic binder was appropriate for the injury or potential to cause harm Krieg JC, Mohr M, Ellis TJ, Simpson TS, Madey SM, Bottlang M: Emergent stabilization of pelvic ring injuries by controlled circumferential compression: A clinical trial. J Trauma 2005;59:

 76 cases 33 Pelvic injury No binder 16 Pelvic injury Binder 27 No Pelvic injury Binder

A-14B-32 C-3

 Correct position level of greater trochanter  43 cases binder applied  irrespective of indication Correct position 36 Incorrect position 7

3 Appropriate

5 cases would have significantly benefited from a binder

6 of 43 cases a binder was applied had potential for injury

Pelvic binders applied in the pre hospital phase  Placed in the correct position 36/43 (84%)  Clinical examination on scene poorly discriminates on injuries needing a binder  Binder applied 43 times  27 (63%) No pelvic injury  16 (37%) Pelvic injury BUT only needed in 3 (7%)  6 (14%) Potential for harm