In the field, how should a suspected pelvic fracture be managed?

• A. Stabilize pelvis with a pelvic binder or wrap; limit movement; monitor for shock; prepare for evac
• B. Apply traction to both legs to realign pelvis
• C. Administer heavy fluids before stabilization
• D. Remove binder after 5 minutes to assess pain

Answer: (A)

In the field, a suspected pelvic fracture demands immediate stabilization to control bleeding and protect the patient during transport. A pelvic binder or wrap compresses the pelvic ring, reducing pelvic volume and helping tamponade bleeding, which can be life-saving when hours matter. Keeping the pelvis immobilized limits further injury from movement as you move the patient to definitive care. Along with stabilization, continuously monitor for signs of shock because pelvic hemorrhage can deteriorate rapidly; watch vital signs, skin perfusion, and mental status, and support airway, breathing, and circulation as needed. Plan for rapid evacuation to a facility capable of definitive management, such as interventional radiology or surgery.

Traction on the legs is not appropriate for a pelvic injury, as it targets other fractures and won’t stabilize the pelvis or control bleeding. Large fluid boluses before pelvic stabilization can worsen bleeding and delay proper hemorrhage control. Removing the binder early would undo stabilization and risk rebleeding, so it should stay in place until definitive care is reached.