Fractured Pelvis:
Haemodynamically UNSTABLE
*OTHER CAUSES OF INSTABILITY
External exsanguinating
Haemorrhage
Tension pneumothorax /
Haemothorax
Cardiac tamponade
Primary Survey ABCDE
Address life-threatening injuries as per EMST
CXR / Pelvic x-ray
Pelvic Binder
Haemostatic resuscitation / MTP
Consider Code Crimson
Notify Interventional Radiology
Notify Orthopaedics
Perform FAST
No
No
No
Yes
Yes
Contrast extravasation
Yes
Yes
ICU
or
PATIENT
PERI-ARREST
Consider
REBOA
Reconsider other causes
of cardiovascular
instability
No
Operating Room
Pre-peritoneal packing
Haemodynamically
stable?
Haemodynamically
stable?
Angiography
No
Yes
Negative
Equivocal
Positive
DPA
Positive
Negative
Angiography available
< 30 mins?
CT Scan
Haemodynamically stable
Operating Room
Pre-peritoneal packing (PPP)
Laparotomy
+/- External fixation