New Guidelines in the Works for Pelvic Injury Devices

Immediate care after pelvic injury is crucial to reduce the risk of life-threatening hemorrhage. This can be done with a variety of binders, belts, slings and even bed sheets. To date, there is no standard guide for these devices used for circumferential compression, and the design of many prevent placement on a patient for optimum application of force or do not confine the force to a safe, effective range.

“If you have a lot of devices, each saying they’re helpful for reducing or stabilizing the pelvis, it seems reasonable to develop a standard that would help improve them,” says Seth Scheinberg, MD, a board-certified orthopedic surgeon and member of ASTM Subcommittee F30.01 on EMS Equipment, which is working to create a new standard: Guide for Selection and Use for Pelvic Ring Circumferential Compression Stabilization Devices (PRCCSD). The guide will establish minimum standards for pelvic slings, belts and binders used in circumferential compression procedures.

“The whole idea of developing this standard is not to rule out people’s products, but to try to get them to improve what they’re doing,” says Scheinberg. Some of the design recommendations will include:

• Should allow access for urinary catheters
• Should allow access to femoral vessels
• Should allow access to the pelvic ring for purpose of external fixation (inserting pins)
• Should not impede movement of patient when used in conjunction with spineboards or stretchers
• Device should not alter position of the patient’s spine
• Device should be packaged with instructions for application and removal
• Should be functional over extreme ranges of ambient temperature and not be affected by changes in altitude
• Should (ideally) configure to allow ease of application by a single practitioner.

“If a manufacturer says a product is safe and effective, they should be able to support their claim with scientific testing, not just with testimonials from people who say they have used it and like it,” says Scheinberg. “All of the recommendations are pretty simple, reasonable things. If somebody sells a device, we want it to be safe, effective, easily applied by one person and packaged with instructions.”

—MN