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72 passage(s) dans 17 référentiel(s).

• JTS — High Bilateral Amputations and Dismounted Complex Blast InjuryJTS
  • p. 10team leader; these surgeries require a team approach with constant communication.20 Hemorrhage control of traumatic amputations and peri-pelvic sources is the main priority along with restoration of blood volume and keeping the patient warm. Pelvic and perineal ... atypical rotational flap in the face of destroyed or missing conventional flap tissue. If the pelvic ring is unstable, a pelvic external fixator should be used instead of a binder, to facilitate access to the groins, debridement
  • p. 7aortic) REBOA would provide inflow control for high AKAs (not amenable to a high and tight TQ) and pelvic/perineal injuries from DCBI. Proper REBOA use requires training and should be done by an experienced provider. If the casualty ... Useful preoperative studies include chest radiograph, anterior-posterior pelvic radiograph, and a Focused Assessment with Sonography for Trauma exam. Preoperative studies should be utilized to identify source(s) of hemorrhage, but blood transfusion and initial hemorrhage control should
  • p. 4these causalities die from hemorrhage. The DCBI pattern of injuries consists of:  bilateral (generally proximal) lower extremity amputations  pelvic/perineal injuries to include testicular and penile injuries  usually, an upper extremity amputation/injury  open pelvic fractures  spinal fractures, more commonly
  • p. 9that colostomy can usually be avoided. Colostomy is indicated in DCBI patients with diagnosed rectal injury or massive pelvic disruption/open pelvic fracture with extremely high suspicion for anorectal injuries. There is rarely a need to do a colostomy ... these complex patterns due to weapons holding stance. Optimal orthopedic care entails: 1. Ensuring extremity hemorrhage control 2. Pelvic external fixation if there is hemorrhage from a pelvic fracture, especially with sacroiliac disruption 3. Stabilization of extremity fractures

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• JTS — U.S. Army Aeromedical Evacuation Standard Medical Operating GuidelinesJTS
  • p. 22tenderness, distention, dissymmetry • Absent / diminished bowel sounds • Grey-Turner sign • Cullen sign • Kehr’s sign Treatment • Blunt abdominal / pelvic injury o Serial physical exams / reassessment o Pelvic binder o Conduct FAST exam if possible** o Focus on resuscitation ... Penetrating abdominal / pelvic injury o Hemostatic dressing o Abdominal / pressure dressing o Direct pressure o Pelvic binder o AAJT- uncontrolled pelvic bleed • Damage Control Resuscitation o Consider implementation of DCR if indications
  • p. 167TABLE OF CONTENTS 167 HEMORRHAGE CONTROL PROCEDURES (cont.) • In pelvic wounds – utilize pelvic binding to limit capacity for hemorrhage (tie pelvis with sheet/commercial binder). o For external hemorrhage of the head and neck where the wound edges
  • p. 169amputation not amendable to a standard tourniquet, non-compressible hemorrhage in a transition zone (inguinal and axilla), and pelvic immobilization. CONTRAINDICATIONS: • None PROCEDURE: All medical personnel should be proficient in deploying and applying all available tourniquets. Junctional tourniquets ... Remove clothing as necessary to visualize area of application if possible. Remove objects from patient's pockets or pelvic area. Slide device into place as necessary to proper position. • Tighten tourniquet by twisting or pumping up balloon/bladder until
• OMS / CICR — Basic Emergency Care (cahier du participant)OMS · CICR · IFEM
  • p. 192with sterile, saline-soaked gauze or towel. • Give tetanus vaccination. • Begin IV antibiotics. IMMOBILIZATION SKILL STATION: APPLYING A PELVIC BINDER Pelvic fractures can cause life-threatening haemorrhage by damaging blood vessels adjacent to the fractures. If a person ... ring, the binder will bring together the displaced bones and help limit internal bleeding. Signs of pelvic fractures include pain or abnormal movement of the pelvis on exam; bruising around the hips, at the top of legs
  • p. 228Give IV fluids, nothing by mouth. Cover visible bowel with sterile gauze soaked in sterile saline, give antibiotics. Pelvic fracture Give IV fluids, stabilize with sheet or pelvic binder. Fracture with poor limb perfusion Reduce fracture, splint. Open ... head, neck or torso • Blast or crush injuries • Flail chest • Two or more large bone fractures, or pelvic fracture • Spinal injury • Limb paralysis • Amputation above wrist or ankle SPECIAL CONSIDERATIONS IN CHILDREN • Children can look well but then
  • p. 68trauma 606060 Management of specific injuries found during secondary survey CONDITION SIGNS AND SYMPTOMS IN-DEPTH MANAGEMENT Pelvic fracture • Pain with palpation of the pelvis • Instability or abnormal movement of the pelvic bones • Blood at opening ... pelvis or perform repeat exams as this can worsen internal bleeding. • Stabilize the pelvis with a sheet or pelvic binder. [See SKILLS] • Plan for early handover/transfer to a unit with blood transfusion capabilities. Extremity fracture with poor perfusion
  • p. 195open fracture will require tetanus vaccination, if not up to date, and antibiotics. Comments: Skill 7 – Applying a pelvic binder Identify pelvic pain after trauma. Place bed sheet under the pelvis. If bed sheet is wide, fold ... cause the person undue pain. It should feel firm but not overly painful. Document the time the pelvic binder was applied. Comments: Competency demonstrated YES NO Remediation required YES NO Signature of facilitator

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• TCCC Guidelines — 1er mai 2026CoTCCC / Joint Trauma System
  • p. 5continuous EtCO2 and SpO2 monitoring to help assess airway patency. 6. Circulation a. Bleeding 1. A pelvic binder should be applied for cases of suspected pelvic fracture: Severe blunt force or blast injury with one or more ... following indications:  Pelvic pain  Any major lower limb amputation or near amputation  Physical exam findings suggestive of a pelvic fracture  Unconsciousness  Shock 2. Expose and clearly mark all tourniquets with the time of tourniquet application. Note tourniquets applied
• IFRC — International First Aid, Resuscitation and Education Guidelines 2020IFRC — Global First Aid Reference Centre
  • p. 229alcohol or drugs) may be less likely to be able to recognise they have a spinal injury. Pelvic fracture First aid providers need specific training to recognise a pelvic fracture. Pelvic fracture may be associated with spinal injury ... person with a pelvic fracture may: • Experience pain at the hip, pelvis, groin or even the knee. This gets worse when moving. • Not be able to support his legs. Sometimes, the foot (on the side of the fracture
  • p. 228cases of suspected spinal injury, a head injury should also be considered. • Where the injury includes a suspected pelvic fracture, the first aid provider may apply a pelvic binder and avoid rotating the pelvis. Chain of survival behaviours
  • p. 230International first aid, resuscitation, and education guidelines 2020 Pelvic fracture 1. Help the person to lie down on their back and to keep still with their legs straight. 2. Place padding between their legs and then immobilise their ... follow their instructions. • Monitor their breathing and level of response for any changes. NOTE If you suspect a pelvic fracture, do not ‘rock’ or rotate the pelvis as this can restart or worsen bleeding
• OMS — Managing Complications in Pregnancy and Childbirth (2e éd.)OMS
  • p. 274endometritis is a major cause of maternal death. Delayed or inadequate treatment of postpartum endometritis may result in pelvic abscess, peritonitis, septic shock, deep vein thrombosis, pulmonary embolism, chronic pelvic infection with recurrent pelvic pain and dyspareunia, tubal
  • p. 160breasts, bluish discolouration of vagina and cervix, softening of cervix, slight uterine enlargement, increased urinary frequency) • Abdominal and pelvic pain • Collapse and weakness • Fast, weak pulse (110 beats per minute or more) • Hypotension • Hypovolaemia • Acute abdominal and pelvic ... DIFFERENTIAL DIAGNOSIS The most common differential diagnosis for ectopic pregnancy is threatened abortion. Others are acute or chronic pelvic inflammatory disease, ovarian cysts (torsion or rupture), and acute appendicitis. If available, ultrasound can help to distinguish a threatened
  • p. 21Obstructed labour S-83 Occiput posterior position S-91 Occiput transverse position S-88 Ovarian cysts S-138 Pelvic abscess S-131 Pelvic inflammatory disease S-16 Perineal tears (first and second degree) P-98 Perineal tears (third
  • p. 234presenting parts. On abdominal examination, the head is felt in the upper abdomen and the breech in the pelvic brim. Auscultation locates the fetal heart higher than expected with a vertex presentation. On vaginal examination during labour

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• FPHC — Désincarcération après accident de la routeFaculty of Pre-Hospital Care (RCSEd)
  • p. 12pelvic binder is indicated, this should be applied after the process of extrication is complete. [IV D] Applying a binder whilst a patient remains in the car is technically challenging, may not result in optimum placement ... contribute to extended entrapment times. Patients with suspected major pelvic injury should be extricated using the quickest appropriate extrication technique (likely a rapid extrication technique) and re-assessed following extrication. If a pelvic binder is indicated, it should
  • p. 19follow instructions, § Injuries or baseline function that prevents standing on at least one leg, (specific injuries include: unstable pelvic fracture, impalement, bilateral leg fracture) - All patients with evidence of injury should be considered time-dependent and their entrapment ... beyond the extrication phase. o Kendrick Extrication Devices prolong extrication time, and their use should be minimised. o Pelvic slings should not be applied to patients until they have been extricated. o Cervical collars should only be used
  • p. 17more likely to be trapped than males[2] and have a higher incidence of spinal[3] and pelvic[4] injuries. Male patients have a higher incidence of head[5], chest[6] and limb injuries[7]. Study 4 demonstrated
  • p. 27during entrapment should be limited to necessary critical interventions to expedite safe extrication [IV D] 12. If a pelvic binder is indicated this should be applied after the process of extrication is complete [IV D] 13. The psychological
• NHTSA — National EMS Education Standards 2021NHTSA
  • p. 51Dislocations (F,F) • Amputations/replantation (F,F) • Upper and lower extremity orthopedic trauma (F,F) • Sprains/strains (F,F) • Pelvic fractures (F,F) • Open fractures (F,F) • Closed fractures (F,F) • Dislocations (F,F) • Amputations/replantation (C,F) • Upper and lower ... extremity orthopedic trauma (F,F) • Sprains/strains (F,F) • Pelvic fractures (C,F) • Open fractures (C,C) • Closed fractures (C,C) • Dislocations (C,C) • Amputations/replantation (C,F) • Upper and lower extremity orthopedic trauma (C,C) • Sprains/strains (F,F) • Pelvic
• JTS — Damage Control Resuscitation in Prolonged Field CareJTS
  • p. 21recognize need for DCR based on: • Severe injury pattern: proximal, bilateral, or multiple amputations; penetrating injury to chest/abdomen; pelvic or junctional hemorrhage • Altered mental status (in absence of TBI) • Weak/absent radial pulse If initial survey does not indicate ... hemorrhage and reduce internal hemorrhage per TCCC guidelines. • Limb tourniquets • Wound packing • Pressure dressings • Hemostatic dressings • Junctional tourniquets • Pelvic binders Emerging technologies: • AAJT • REBOA • ≤30 minutes inflation time, see protocol for use. Resuscitation—products of choice for casualties
  • p. 3severe injury pattern.  Injury pattern consistent with massive hemorrhage:  Above-the-knee traumatic amputation, especially if associated with pelvic injury
  • p. 5Clinical Judgment 5  Pressure dressings  Hemostatic dressings (Combat Gauze, Celox Gauze, Chito Gauze, and XStat  Junctional tourniquets  Pelvic binders TOURNIQUET NOTES 9  Tourniquets (limb and junctional) should be transitioned to pressure dressings within 2 hours when criteria
  • p. 6abdominal hemorrhage or traumatic arrest) or the distal aorta above the aortic bifurcation (zone III, for pelvic and/or junctional lower extremity hemorrhage). Balloon time should be limited to 30 minutes for zone I. Maximum zone III inflation time

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• JTS — Drowning ManagementJTS
  • p. 10victims without evidence of trauma. In unconscious patients, in addition to a CT head and neck, perform a pelvic X- ray as pelvic fracture can be a significant source of bleeding. In drowning victims with persistent hypotension without
• JTS — Vascular InjuryJTS
  • p. 35injuries of the thoracic aorta and brachiocephalic vessels (subclavian and carotid) and select patterns of solid organ and pelvic injury amenable to coil embolization. Placement of vena cava filters to reduce the risk of pulmonary thromboembolic events ... pulmonary embolism (progression or bleeding). Examples of contraindications to chemoprophylaxis include significant traumatic brain, solid organ, or pelvic injuries with bleeding (refer to JTS Prevention of Venous Thromboembolism CPG). The Günther-Tulip (Cook Medical, Inc.) filter is currently
  • p. 30clamps facilitate low-profile control of iliac arteries. Iliac artery injuries generally present as a Zone III or pelvic hematoma with or without extremity ischemia (check femoral pulses). Exploration of the hematoma should be performed after proximal control
  • p. 31endovascular capabilities, selective embolization of bleeding hypogastric artery or branches is an option, particularly in blunt trauma (e.g., pelvic fracture.) The principles which apply to the management of iliac vein injury are discussed in the Management of Large
• JTS — Emergent Resuscitative ThoracotomyJTS
  • p. 5REBOA Recently, the technique of REBOA has emerged in the setting of trauma for control of abdominal and pelvic hemorrhage. Although not strictly comparable, REBOA is a potential alternative to ERT to achieve aortic occlusion and, therefore, control ... abdominal and pelvic hemorrhage. Several recent studies tried to compare REBOA and ERT in non-compressible torso hemorrhage16-18, and a meta-analysis is available.19 Even if REBOA seemed to be associated with a lower mortality, there
• JTS — Prolonged Casualty Care GuidelinesJoint Trauma System (DoD)
  • p. 18tourniquet that has been in place more than 6 hours.  Initiate hypothermia prevention measures.  If present, assess pelvic compression device and verify placement and tightness.  IV or intraosseous (IO) access if not already initiated in MARCH interventions
• FPHC — Arrêt cardiaque traumatique (position 2024)Faculty of Pre-Hospital Care (RCSEd)
  • p. 4cardiac arrest, blood flow is minimal and sources of external haemorrhage may not be obvious. Application of a pelvic binder or a tourniquet onto a bleeding extremity can prevent further blood loss if ROSC is achieved. Recommendation: Rapidly
• FAA — Projet de refonte de la trousse médicale (NPRM 2026)FAA
  • p. 5childbirth, which may include the following signs and symptoms: contractions, water breaking, vaginal discharge, back pain, or pelvic pressure. Treatment options could include equipment such as a delivery kit. FAA relied on the AsMA report to formulate this
• JTS — Joint En Route Care GuidelinesJTS
  • p. 4provider will have to perform assessment. b. Catalogue all injuries, this includes rolling the patient (using spinal and pelvic precautions depending on injuries). Assess airway, breathing (auscultate lung fields and palpate the chest for expansion) and ensure
  • p. 17teaspoons of granulated sugar with ½ teaspoon of table salt in 1 liter of water). Assess pelvis and apply pelvic compression device (PCD) if indicated. If PCD previously placed, assess integrity and position of PCD, particularly after casualty movement
  • p. 42sensory checks should be performed routinely. If any are diminished, cast/dressings must be loosened (bivalve) or removed. Pelvic binders and/or Junctional Hemorrhage devices shall be routinely checked for proper placement and security, especially after casualty transfers. In flight
  • p. 57Total Burn Surface Area TCCC Tactical Combat Casualty Care TXA Tranexamic Acid OTFC Oral transmucosal fentanyl citrate PCD Pelvic compression device POI Point of injury UOP Urine output En Route Care Guidelines
• JTS — Prehospital Blood TransfusionJTS
  • p. 5following criteria for transfusion: signs and symptoms of hemorrhagic shock; OR 1+ amputation; blunt/penetrating trauma (junctional/abdominal/thoracic); OR pelvic fracture; OR SBP <100; OR lactate >5; pulse >100.20 In Australia, the Greater Sydney Area Helicopter Emergency Medical Services
  • p. 12radial pulse; or  Altered mental status with signs/symptoms hemorrhagic shock; or  Penetrating trauma to chest/abdomen, junctional injuries; or  Pelvic fracture; or  Any above knee amputation or multiple amputations (regardless of vital signs) DURING 1. Obtain IV/IO access
  • p. 13Traumatic injuries where early blood transfusions are most likely to be needed:  Penetrating thoracic/abdominal/junctional (junctional includes axilla/inguinal/cervical) injury.  Pelvic fracture.  Multiple injuries.  Proximal amputations (above knee or elbow). Amputation is defined as any severe trauma to a limb