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Pelvic crush injury — DipIMC MCQ

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EasyPre-Hospital Trauma ManagementPelvic crush injuryDipIMC

A 46-year-old man has been crushed by a forklift across the pelvis for 25 minutes. He is now released, confused, hypotensive and complaining of pelvic pain. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Control pelvic movement with a binder and request major trauma pre-alert

The scenario suggests unstable pelvic injury with haemorrhagic shock. Early pelvic binder application and rapid movement along a major trauma pathway are appropriate. Normalising blood pressure with crystalloid can dilute clotting factors and worsen bleeding before haemorrhage control. The pearl is that pelvic bleeding is often hidden, and scene time should be minimised once lifesaving interventions are complete.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025