Abstract
Fractures of the pelvis sustained as a result of high-energy trauma represent a significant challenge to the advanced practice nurse and trauma team (Frakes & Evans, 2004) with certain types of open fractures of the pelvis having mortality rates approaching 100% (Dente et al., 2005). Because of the potential for significant mortality, it is vital to recognize those fractures with a high potential for significant blood loss. The initial assessment of the patient with a suspected pelvic fracture requires an appreciation of the energy involved in the trauma and the initial vital signs. The purpose of rapid assessment is to estimate whether or not an individual practitioner and institution are capable of caring for this type of critically injured patient if one is not located in a Level I trauma center possessing a multidisciplinary team, capable of arterial embolization, prompt surgical intervention, including preperitoneal pelvic packing. In most Level I trauma centers, protocols have been developed and refined for dealing with the high-energy pelvic fracture patient; however, it is also appropriate for all institutions to develop protocols for management of pelvic fractures with one salient alternative being an early decision to transfer the patient for definitive care (Barzilay, Liebergall, Safran, Khoury, & Mosheiff, 2005; Biffl et al., 2000; Durkin, Sagi, Durham, & Flint, 2006; Heetveld et al., 2004).