open access

Vol 8, No 3 (2023)
Case report
Published online: 2023-07-26
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Pre-hospital management of penetrating pelvic injuries — a case study

Karol Przegalinski1, Marek Dabrowski2, Edward Dabrowski3, Agata Dabrowska4, Mateusz Puslecki45, Ryszard Marciniak2
DOI: 10.5603/DEMJ.a2023.0028
·
Disaster Emerg Med J 2023;8(3):175-179.
Affiliations
  1. Department of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
  2. Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
  3. EPSU English Programs’ Student Union, Poznan University of Medical Sciences, Poland
  4. Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland
  5. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poland

open access

Vol 8, No 3 (2023)
CASE REPORTS
Published online: 2023-07-26

Abstract

INTRODUCTION: Penetrating pelvic injuries and the complications caused by them are a global problem in the provision of services by emergency medical teams. They often pose a significant challenge for medical personnel, particularly in patient evacuation and stabilization during transport.

CASE REPORT: The emergency medical service (EMS) was dispatched to a traffic accident — the report contained information about one conscious victim with a foreign body within the patient’s body. At the accident scene, a delivery truck crashed into the tow bar of a trailer standing on the road, and one person was seriously injured due to the impact. The preliminary assessment confirmed a foreign body penetrating the right thigh, deformation and enlargement of the thigh contour, pain in the thigh, pelvis, and tenderness in the thoracic-lumbar spine with the end part of the tow bar hook palpable under the skin. The victim was suspected of having a femur fracture, pelvic injuries, and damage to internal organs. On neurological examination, sensation and motor functions were preserved in all limbs. The evacuation procedure was established after the Fire Department (FD) rescuers arrived. The injured person was removed from the vehicle on an orthopedic board with the help of eight rescuers. The victim was placed on his left side with the right side elevated, with continuous manual stabilization supported by a blanket, pillows, and orthopedic boar straps.

CONCLUSIONS: Each traumatic injury event requires selecting and using the appropriate equipment. A good compromise between speed and precision of actions should not significantly contribute to the worsening of the injury. An increase in a rescuer’s substantive knowledge on how to proceed in the case of this type of trauma and injuries, as well as close cooperation with the fire department, will undoubtedly result in more appropriate actions.

Abstract

INTRODUCTION: Penetrating pelvic injuries and the complications caused by them are a global problem in the provision of services by emergency medical teams. They often pose a significant challenge for medical personnel, particularly in patient evacuation and stabilization during transport.

CASE REPORT: The emergency medical service (EMS) was dispatched to a traffic accident — the report contained information about one conscious victim with a foreign body within the patient’s body. At the accident scene, a delivery truck crashed into the tow bar of a trailer standing on the road, and one person was seriously injured due to the impact. The preliminary assessment confirmed a foreign body penetrating the right thigh, deformation and enlargement of the thigh contour, pain in the thigh, pelvis, and tenderness in the thoracic-lumbar spine with the end part of the tow bar hook palpable under the skin. The victim was suspected of having a femur fracture, pelvic injuries, and damage to internal organs. On neurological examination, sensation and motor functions were preserved in all limbs. The evacuation procedure was established after the Fire Department (FD) rescuers arrived. The injured person was removed from the vehicle on an orthopedic board with the help of eight rescuers. The victim was placed on his left side with the right side elevated, with continuous manual stabilization supported by a blanket, pillows, and orthopedic boar straps.

CONCLUSIONS: Each traumatic injury event requires selecting and using the appropriate equipment. A good compromise between speed and precision of actions should not significantly contribute to the worsening of the injury. An increase in a rescuer’s substantive knowledge on how to proceed in the case of this type of trauma and injuries, as well as close cooperation with the fire department, will undoubtedly result in more appropriate actions.

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Keywords

traumatology; pelvic injury; pelvic fractures; foreign body

About this article
Title

Pre-hospital management of penetrating pelvic injuries — a case study

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 8, No 3 (2023)

Article type

Case report

Pages

175-179

Published online

2023-07-26

Page views

177

Article views/downloads

185

DOI

10.5603/DEMJ.a2023.0028

Bibliographic record

Disaster Emerg Med J 2023;8(3):175-179.

Keywords

traumatology
pelvic injury
pelvic fractures
foreign body

Authors

Karol Przegalinski
Marek Dabrowski
Edward Dabrowski
Agata Dabrowska
Mateusz Puslecki
Ryszard Marciniak

References (15)
  1. Data of the Central Statistical Office in Poland 2018. https://stat.gov.pl (27.02.2023).
  2. Act of 8 September 2006 on State Medical Rescue Journal of Laws 2019 item 993, ACT of 10 May 2018 amending the Act on State Emergency Medical Services and certain other acts, Regulation of the Minister of Health of 18 June 2010 on the trauma center. https://isap.sejm.gov.pl (27.02.2023).
  3. Brongel L, Lasek J, Słowiński K. Podstawy współczesnej chirurgii urazowej. Wydawnictwo Medyczne, Kraków 2008: 325–335.
  4. Chawda MN, Hildebrand F, Pape HC, et al. Predicting outcome after multiple trauma: which scoring system? Injury. 2004; 35(4): 347–358.
  5. Ford EG. Chapter 4: Trauma Triage. In: Ford EG, Andrassy RJ. ed. Pediatric Trauma - Initial Assessment and Management. W B Saunders Company, Philadelphia 1994: 95–117.
  6. Kirkpatrick JR, Youmans RL. Trauma Index: an aide to the evaluation of injury victims. J Trauma. 1971; 11(8): 711–714.
  7. Nowakowski A, Kaczmarczyk J, Michalski P, Pasciak M, Kubaszewski L, Caban A. Ortopedia i traumatologia regionalna. Wydawnictwo Exemplum, Poznan 2017.
  8. Gawlowski P, Biskup A. Victim evacuation techniques in emergency conditions. Disaster Emerg Med J. 2019; 4(3): 116–123.
  9. Ladny M, Gawel W. Neck stabilization in trauma patient: an emergency medicine perspective. Disaster Emerg Med J. 2022; 7(1): 52–57.
  10. Campbell JE, Alson RL. ITLS International Trauma Life Support. Ratownictwo przedszpitalne w urazach, wydanie VII. Medycyna Praktyczna, Kraków 2017: wydanie.
  11. Lazarev A, Golokhvast K, Borozda I. Review of the problems of diagnosis of endopelvic haemorrhage, its intensity, volume, and duration, and treatment methods of circulatory injuries and surgical hemostasis after pelvic fractures. Emerg Med Int. 2019; 2019: 2514146.
  12. Goslings JC, Ponsen KJ, van Delden OM. ACS Surgery: Principles and Practice: Decker Intellectual Properties” 2013. Injuries to the pelvis and extremities.
  13. American College of Surgeons Advanced trauma life support. 7th edn. Chicago, IL: American College of Surgeons, Chicago 2004.
  14. Waikakul S, Harnroongroj T, Vanadurongwan V. Immediate stabilization of unstable pelvic fractures versus delayed stabilization. J Med Assoc Thai. 1999; 82(7): 637–642.
  15. Lee C, Porter K. The prehospital management of pelvic fractures. Emerg Med J. 2007; 24(2): 130–133.

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