Current Management of Hemodynamically Unstable Patients with Pelvic Fracture

Purpose of Review Trauma patients with a high-energy mechanism may sustain severe pelvic injury, leading to increased mortality from hemorrhage. Hemodynamic instability in the setting of pelvic injury should be rapidly addressed using the available resources. Recent Findings Initial resuscitation utilizing ATLS teachings and necessary blood products is initiated while pelvic volume reduction can be achieved with a pelvic binder. REBOA may be employed to stabilize patients with pelvic bleeding, allowing for further intervention. Preperitoneal pelvic packing, external fixation, and angioembolization are techniques to address hemorrhage within the bony pelvis. Summary A multidisciplinary and multimodal approach is needed in the treatment of complex pelvic injuries. Arresting pelvic hemorrhage is imperative in hemodynamically unstable patients with pelvic injuries.