Pelvic Binders

Most of our patients come in with their binders already on, but sometimes we do have to apply them.

Why
- tamponade blood
 (yet pelvis has space for a baby and a beer filled bladder)
- oppose bone ends and stop bleeding

Why not
There is no evidence that pelvic binders are harmful when applied to patients with proximal femur or acetabular fracture.
They can cause pressure necrosis
Depending on the mechanism, they may make the injury worse.

How
Strip patient - should be to skin
Analgesia
Roll patient to 15 degrees
Put folded binder underneath buttocks

Apply over the greater trochanter or symphysis pubis
Minimise patient movement - ideally they should be scooped on.

SAM Splint:
  Feed black strap through the buckle
  Pull black and orange in opposite directions
  Tighten
  Fasten

Pregnancy - should be OK if applied correctly

Pelvic binders. Do we slide up from knees to GTs, or tilt onto a folded binder? Can't find a consensus! #foamed @JGoulding444 @mattdoc1979

— Charlotte Davies (@OneLongPlait) November 3, 2015

Good Resources
https://phemcast.co.uk/2015/11/05/podcast-episode-2-the-pelvic-binder/
https://www.rcemlearning.co.uk/references/abdominal-trauma/ 
https://www.rcemlearning.co.uk/foamed/pelvic-fractures-a-guide-to-treatment-within-a-trauma-unit/ 
https://www.rcemlearning.co.uk/foamed/june-2017/#1496133043616-a1f3a145-a4a3 
https://www.rcemlearning.co.uk/modules/blunt-trauma-to-the-abdomen-don’t-forget-the-kidneys/
http://emergencymedicineireland.com/2013/04/anatomy-for-emergency-medicine-027-basic-anatomy-of-abdomen-and-pelvic-trauma/ 
https://www.resus.com.au/2015/07/31/unstable-pelvic-fractures/ 
https://emj.bmj.com/content/30/12/1070