By Philip Neuwirth, BS, MICP, CCEMTP, FP-C
Here we are in 2016 and some programs are still undecided whether commercial Pelvic Stabilization Devices should be used in the prehospital setting. Multiple clinical studies have indicated Pelvic Stabilization devices improve pelvic fracture outcomes, decrease mortality and multiple organ failure from exsanguination. And, by the way cost only about $120.
A research paper published in 2001; Evolution of a Multidisciplinary Clinical Pathway for the Management of Unstable Patients With Pelvic Fractures by Walter L. Biffl, MD, et al concluded that, “a higher proportion of patients in the late period had blood pressure less than 90 mmHg (52% vs. 35%). In the late period, diagnostic peritoneal lavage was phased out in favor of torso ultrasound as a primary triage tool, and pelvic binding and C-clamp application largely replaced traditional external fixation devices. The overall death rate decreased from 31% in the early period to 15% in the later period, as did the rate of deaths from exsanguination (9% to 1%), multiple organ failure (12% to 1%), and death within 24 hours (16% to 5%).” So, they concluded, … improved patient survival. The primary benefits appear to be in reducing early deaths from exsanguination and late deaths from multiple organ failure.
This link is a paper written by Dr Alan Moloff who reviewed four clinical studies that indicate Pelvic Stabilization Devices improve fracture outcomes. The 3rd study evaluated and compared a standard bed sheet (folded to a width of approximately 8 inches and wrapped circumferentially around the pelvis and greater trochanters) to pelvic stabilization by applying a T-POD (Pyng Medical – and also applied circumferentially around the pelvis and greater trochanters).
- Statistically significant improvement in diastasis was seen when using a POD device (T-POD) compared to the utilization of bed sheets, for pelvic fractures, when compared with injury measurements.
- Critical improvement in mean arterial pressure and heart rate was seen when using a POD device on pelvic fracture patients.
- A statistically significant improvement in patient mortality was seen utilizing a protocol that emphasized rapid pelvic stabilization for pelvic fractures.
- A statistically significant improvement in transfusion requirement and hospital length-of-stay was seen when using a POD device over external pelvic fixation for blunt pelvic fractures.
He concluded by saying, “The data is overwhelming that the utilization of POD devices improves pelvic fracture patient outcomes and that POD devices are superior to Sheets and/or EPF in critical areas such as closure of diastasis, transfusion rates, and length of hospital stay.
As always, please post your comments, disagreements and/or experiences. Or, please send me an email with any questions or comments. Thx!
This blog is not a replacement for reading the literature on your own. The views and opinions expressed are my own, based on my own experiences in the field of critical care medicine and do not represent those institutions with whom I am affiliated. I have no affiliation, nor am I compensated for any products mentioned.