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Unstable pelvic fracture — ABEM Board MCQ

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HardTraumaUnstable pelvic fractureABEM Board

A 45-year-old man arrives after being crushed by machinery. Triage acuity is ESI 1; BP 72/40 mm Hg, HR 142/min. Pelvis is unstable on gentle compression, and there is blood at the urethral meatus. Breath sounds are equal, and FAST is negative. Which of the following is the most appropriate initial action?

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Correct answer: C — Apply a pelvic binder and activate massive transfusion

Unstable pelvic fracture with shock requires immediate pelvic stabilization and hemorrhage resuscitation; urethral injury makes blind Foley placement unsafe.

Reference: ATLS trauma guidance