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An arm sling holds the forearm in a raised or horizontal position and can support an injured upper arm, forearm and wrist. The sling is also a useful visual warning to others that someone is injured.
Bandages can be used to support injured
joints, secure dressings and control bleeding.
Shock - not to be confused with emotional shock – is a life-threatening condition. It happens when the body isn’t getting enough oxygen to the vital organs. Find out what to look for and what to do.
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Abstract
Objective
Pelvic fractures represent 5% of all traumatic fractures and 30% are isolated pelvic fractures. Pelvic fractures are found in 10 to 20% of severe trauma patients and their presence is highly correlated to increasing trauma severity scores. The high mortality of pelvic trauma, about 8 to 15%, is related to actively bleeding pelvic injuries and/or associated injuries to the head, abdomen or chest. Regardless of the severity of pelvic trauma, diagnosis and treatment must proceed according to a strategy that does not delay the management of the most severely injured patients. To date, in France, there are no guidelines issued by healthcare authorities or professional societies that address this subject.
Design
A consensus committee of 22 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d’Anesthésie et de Réanimation; SFAR) and the French Society of Emergency Medicine (Société Française de Médecine d’Urgence; SFMU) in collaboration with the French Society of Radiology (Société Française de Radiologie; SFR), French Defence Health Service (Service de Santé des Armées; SSA), French Society of Urology (Association Française d’Urologie; AFU), the French Society of Orthopaedic and Trauma Surgery (Société Française de Chirurgie Orthopédique et Traumatologique; SOCFCOT), and the French Society of Digestive Surgery (Société Française de Chirurgie digestive; SFCD) was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently from any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised.
Methods
Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the recommendations were then conducted according to the GRADE® methodology.
Results
The SFAR Guideline panel provided 22 statements on prehospital and hospital management of the unstable patient with pelvic fracture. After three rounds of discussion and various amendments, a strong agreement was reached for 100% of recommendations. Of these recommendations, 11 have a high level of evidence (Grade 1 ± ), 11 have a low level of evidence (Grade 2 ± ).
Conclusions
Substantial agreement exists among experts regarding many strong recommendations for management of the unstable patient with pelvic fracture.
Keywords
Pelvic trauma
Prehospital setting
Severity criteria
Trauma network
Arterial embolization
Cited by (0)
© 2018 The Author(s). Published by Elsevier Masson SAS on behalf of Société française d'anesthésie et de réanimation (Sfar).