Fractures of the pelvis are found reasonably often in major trauma, but they’re a really challenging presentation. They are difficult to assess and accurately diagnose in the prehospital setting, mortality rates are high, particularly in patients with haemodynamic instability and there are often associated injuries. Associated mortality from patients with pelvic fractures who reach hospital is reported to be up to 19%, with mortality rates as high as 37% reported in the presence of haemodynamic instability.
In this episode we'll run through pelvic injuries, all the way from anatomy and mechanisms of injury, to assessment and management.
As always make sure you have a look at the references and supporting material attached in the show notes, and get in touch with any questions or comments and take care of yourselves.
Simon, Rob and James
So COVID-19 has produced a multitude of challenges to healthcare providers, the response to these challenges has been phenomenal.
One uncertainty is the strategy we should employ for hypoxic respiratory failure and several high quality guidelines have presented conflicting advice for the severely hypoxic patient.
The Warwick Clinical Trials Unit has already begun recruiting patients to their RECOVERY-RS trial, which is open for hospitals in the UK to sign up for. This looks at 3 different strategies of respiratory support for patients admitted with suspected or known COVID-19 and hypoxia; namely CPAP, High-flow nasal oxygen and standard care. The trial is funded by the NIHR and supported by the Intensive Care Society.
In this episode we get a chance to speak to Bronwen Connolly, one of the investigators of the RECOVERY-RS trial; we discuss the background evidence, the trial design, and when results will be available.
As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the protocol yourself.
Simon, Rob & James
First we hope you're all well. The world has changed dramatically over the the last few weeks and you are all doing a phenomenal job of providing healthcare under extremely challenging circumstances.
We are determined to add a bit of normality to life with a non-COVID-19 papers of the month, full of bad jokes and some EBM. This month we're looking at intubation of acute alcohol intoxication in ED. We take a look at a paper that tries to quantify the risk of patients developing an intracerebral injury when taking antiplatelets and anticoagulants. Finally we have a look at the value of clinical examination and imaging findings in patients with elevated intracranial pressure, how valuable are individual findings?
Most importantly take care of yourselves and loved ones and keep fighting the good fight!
Simon & Rob