Preserve clot - minimal movement, gentle handling, minimum of rolling.

Punch anyone who tries to

'spring' the pelvis. Fit pelvic belt on basis of mechanism of injury. Minimal iv fluid to preserve systolic
of 70 (90 mmHg if associated head injury). Take to a hospital that understands the condition!

Timothy J Coats MD FRCS FFAEM

Senior Lecturer in Accident and Emergency/Pre-Hospital Care
Royal London Hospital, UK.

Evidence

Level III

Grant PT "The diagnosis of pelvic fractures by 'springing'." Arch Emerg Med 1990 7(3): 178-
182.

Thirty-six patients were studied prospectively to assess the benefit of 'springing' the pelvis in
traumatized patients, to confirm or refute a fracture of the pelvis. None of the patients was multiply
injured and half of those with fractures were elderly, sustaining their injuries in simple falls. Springing
the pelvis was a poor predictor of the presence or absence of a pelvic fracture, at best it yielded a
specificity of 71% and sensitivity of 59%. Its routine use in clinical examination should be abandoned.

Guide to Evidence Appraisals

The definitions of the types of evidence and the grading of recommendations used originate from the
US Agency for Health Care Policy and Research

Level Type of evidence (based on AHCPR 1992)