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Unstable pelvic fracture — RCPSC EM MCQ

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HardTraumaUnstable pelvic fractureRCPSC EM

A 26-year-old restrained driver arrives CTAS 1 after a high-speed collision. BP is 82/48, HR 138, GCS 14, and the pelvis is unstable with perineal bruising. FAST is negative and chest X-ray shows no haemothorax. Two units of red cells are running through a rapid infuser. What is the most appropriate next step?

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

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Correct answer: E — Apply a pelvic binder at the greater trochanters and activate massive haemorrhage protocol

The physiology and pelvic findings indicate life-threatening pelvic haemorrhage. Early circumferential pelvic stabilisation and balanced transfusion take priority over CT in an unstable patient.

Reference: Trauma Association of Canada and Canadian Blood Services massive haemorrhage resources