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Pelvic fracture haemorrhage — RCPSC EM MCQ

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EasyTraumaPelvic fracture haemorrhageRCPSC EM

A 28-year-old restrained driver is brought after a high-speed collision. He is confused, systolic blood pressure is 88 mmHg and pelvis is unstable on gentle compression. FAST is negative, chest radiograph shows no haemothorax and haemoglobin has fallen from 131 to 104 g/L after 1 L crystalloid. What is the most likely diagnosis?

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Correct answer: C — Pelvic fracture haemorrhage

The combination of pelvic instability, shock, falling haemoglobin and no thoracic or intraperitoneal source strongly suggests pelvic haemorrhage. A pelvic binder and massive haemorrhage protocol are immediate priorities.

Reference: ATLS; Canadian trauma systems guidance