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Unstable pelvic fracture haemorrhage — FRCA Final MCQ

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EasyTrauma and Emergency AnaesthesiaUnstable pelvic fracture haemorrhageFRCA Final

A 28-year-old man arrives after a motorcycle collision with pelvic deformity and hypotension. Heart rate is 138/min, blood pressure 78/40 mmHg, lactate 6 mmol/L and FAST is negative. The pelvis is unstable on gentle assessment. What is the most important next step?

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Correct answer: E — Apply a pelvic binder and activate major haemorrhage protocol

An unstable pelvic fracture with shock requires early pelvic binder application and major haemorrhage resuscitation. Repeated pelvic examination can disrupt clot and worsen bleeding. CT may be needed after initial stabilisation, but unstable patients need haemorrhage control first. Tranexamic acid and balanced blood products should be considered according to major trauma protocols.

Reference: NICE NG39 major trauma; BOAST pelvic fracture guidance