02/04/2026
Are you ready to stop getting your pelvis in a bundle!
Your trauma patient has a high-energy mechanism, pelvic pain, and now theyโre getting tachycardic + hypotensiveโฆ do you automatically throw on a pelvic binder?
NAEMSP just released a position statement on prehospital evaluation and management of suspected pelvic fractures, and one message came through loud and clear:
Pelvic fractures are high-risk, but pelvic binders arenโt the slam dunk we once thought.
Here are the need-to-know takeaways:
โก๏ธ Pelvic fractures can cause massive hemorrhage, but in real trauma patients, shock is often from other injuries too (chest/abdomen/head). If your patient is unstable, donโt tunnel vision on the pelvis. Keep hunting for other bleeding sources.
โก๏ธ Physical exam is NOT reliable for diagnosing pelvic fractures in the field. โSpringingโ or manually compressing the pelvis isnโt sensitive or specific, and it may actually make things worse.
โก๏ธ Pelvic binders (PCCDs) should be reconsidered in many systems. NAEMSP highlights that evidence is insufficient that binders reduce hemorrhage or mortality, and thereโs real risk of improper placement and iatrogenic injury.
If your service currently uses pelvic binders, placement matters. They must go over the greater trochanters (not the abdomen/iliac crests), and the legs should be internally rotated by securing the feet together.
Because pelvic splinting is low-frequency and high-risk when placed incorrectly, agencies should prioritize ongoing training + quality improvement if binders remain in protocol.
Bottom line: suspected pelvic fracture = major trauma patient until proven otherwiseโฆ but binders arenโt a โjust do it every timeโ intervention anymore. Think mechanism, shock, and overall injury pattern, and treat the whole patient.
Full study:https://www.handtevy.com/wp-content/uploads/2025/11/Prehospital-Trauma-Compendium-Evaluation-and-Management-of-Suspected-Pelvis-Fractures-An-NAEMSP-Position-Statement-and-Resource-Document-2.pdf
