國內兩大軍事雜誌《尖端科技》與《天生射手》專欄作家。
你知道骨盆受傷可引發大量失血嗎？
我們以往接觸過幾個這類案例；但不幸的是，我們由於過度自滿，因此沒有在卡車或飛機上準備骨盆固定帶
我找到這兩個關於骨盆骨折的來源，所以分享出來
在一位保持警醒的傷患身上，你會預期有下列明顯的症狀：例如下腹痛，骨盆疼痛，臀部疼痛與背痛
可能發生骨盆骨折的徵兆包括心搏過速，低血壓，腰部瘀青，骨盆．鼠蹊．下腹腫脹，兩腿長度不一等
在創傷之際對骨盆的評估
骨盆腔的實際容量約為一公升半；但由於腹膜後腔受到影響，會導致一個無法以施壓來控制（出血）的空間，導致血液的累積
平均而言，一位體重七十公斤的成人，大約有五公升的血液；而基本上骨盆腔可以容納你全部的出血
•注意：永遠不要去搖晃骨盆腔，從外側到內側輕微地觸診，便足以檢查骨盆是否穩定•
骨盆的穩定
使用一項骨盆穩定器材＂並無法＂限制傷患的骨盆出血；但它至少能有效地限制住骨折的變位，並減少骨盆腔的容血量
民間某些器材（Sam Binder或Cromedical pelvic binders）都是很好的選擇；假設你手邊沒有這類器材的話，可以改用卡車上的布料或其他織物來環繞骨盆，以達到穩定
Did you know you can bleed out in your pelvis?
from @goodmedicineinbadplaces
•
We’ve come across a couple of these in the past. It’s unfortunate we are so large that we don’t carry binder on our trucks or aircraft…yet.
I found these two sources on open book pelvic fractures, so I thought I’d share.
𝗣𝗿𝗲𝘀𝗲𝗻𝘁𝗮𝘁𝗶𝗼𝗻
In an alert trauma patient, you would expect the obvious here: symptoms like abdominal pain, pelvic pain, hip pain, back pain.
Signs of possible pelvic fracture include tachycardia, hypotension, bruising of the flanks, pelvis, or groin, abdominal distention, leg length discrepancy.
𝗔𝘀𝘀𝗲𝘀𝘀𝗺𝗲𝗻𝘁 𝗼𝗳 𝗧𝗵𝗲 𝗣𝗲𝗹𝘃𝗶𝘀 𝗗𝘂𝗿𝗶𝗻𝗴 𝗧𝗿𝗮𝘂𝗺𝗮
True pelvic volume is about 1.5 liters. However, disruption of the retroperitoneum leads to a non-compressible space for hemorrhage to accumulate.
On average, an adult human male who weighs 70 kg has a blood volume of about 5 liters. You can essentially bleed out your entire blood volume into your pelvis.
𝗡𝗘𝗩𝗘𝗥 𝗿𝗼𝗰𝗸 𝘁𝗵𝗲 𝗽𝗲𝗹𝘃𝗶𝘀. 𝗔 𝗴𝗲𝗻𝘁𝗹𝗲 𝗹𝗮𝘁𝗲𝗿𝗮𝗹 𝘁𝗼 𝗺𝗲𝗱𝗶𝗮𝗹 𝗽𝗮𝗹𝗽𝗮𝘁𝗶𝗼𝗻 𝘄𝗶𝘁𝗵 𝗹𝗶𝗴𝗵𝘁 𝗽𝗿𝗲𝘀𝘀𝘂𝗿𝗲 𝗶𝘀 𝗮𝗹𝗹 𝘁𝗵𝗮𝘁 𝗶𝘀 𝗻𝗲𝗲𝗱𝗲𝗱 𝘁𝗼 𝗰𝗵𝗲𝗰𝗸 𝘁𝗵𝗲 𝗽𝗲𝗹𝘃𝗶𝘀 𝗳𝗼𝗿 𝘀𝘁𝗮𝗯𝗶𝗹𝗶𝘁𝘆.
𝗣𝗲𝗹𝘃𝗶𝗰 𝗦𝘁𝗮𝗯𝗶𝗹𝗶𝘇𝗮𝘁𝗶𝗼𝗻
Using a pelvic stabilizing device (an orthotic or sheet binding) does 𝗡𝗢𝗧 seem to limit blood loss in patients with pelvic hemorrhage. It 𝗗𝗢𝗘𝗦, however, effectively reduce fracture displacement and decrease pelvic volume.
Commercially available devices such as the Sam Binder or the Cromedical pelvic binders are great options.
If you don't have one of these devices available, you can use a sheet on your truck or other fabric around the pelvis to facilitate stabilization.
@prepmedic has a great review on the @cromedical device on his YT channel.
Both products are available at @northamericanrescue
Let me know y’all’s experiences with these types of fractures.
#ems #pelvicfractures #openbook #pelvichealth #pelvicpain #trauma #tccc #tecc #tacmed #swatmedic #flightmedic #airrescue
上文承蒙 Casey Chao 先生同意，引用他的「臉書」系列文章，特此致謝！
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