الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
High energy pelvic fractures are life-threatening injuries. Extensive bleeding associated with pelvic fractures is relatively common but is especially prevalent with high-energy fractures. Approximately 15 - 30 % of patients with high-energy pelvic injuries are haemodynamically unstable, which may be directly related to blood loss from the pelvic injury.
Early stabilization of a pelvic fracture is potentially beneficial on multiple levels; it promotes and protects clot formation at fracture site by minimizing motion, diminishes pelvic volume which in theory would help tamponade the venous blood ,contributes to patient comfort ,alleviate the pain and facilitate transport.
Stabilization of a suspected pelvic fracture is an important treatment that can be applied in the field. Continued movement of an unstable pelvic fracture can cause further injury, damage and blood loss. Early control of life-threatening bleeding is the primary goal of on-scene emergency treatment. Our treatment goal is to reduce and stabilize a fractured pelvis. It is theorized that a circumferential pelvic sheet wrap or mechanical device: applies compression so there is less potential space for blood to accumulate in the pelvic cavity.
The aim of our study was to know the effect of early stabilization of pelvic fractures by blanket sheet on the patients admitted to emergency department in Alexandria Main University Hospital from the first of December 2010 to the last of May 2011 and its impact on vital signs in the first 6 hours after admission or till definitive management.
Patients were classified into 3 groups according to Tile classification. All patients were monitored for six hours after admission or till definitive management. And Vital signs were measured before application of blanket sheet and half an hour then after one hour then every two hour for six hours after admission. The Pelvic binders were applied at level of greater trochanters. Resuscitation was done According to Advanced Trauma Life Support (ATLS).
According to our result; the mean value of the age in trauma patients was 36 years and males more liable for trauma than females. The most of pelvic fractures were stable fractures type (A) according to Tile classification. The most common cause of trauma was road traffic accident then falling from height.
As regard to Revised Trauma Score (RTS) it was heavily weighted towards the Glasgow Coma Scale to compensate for major head injury. Group A was statistically higher values than group B and group C because patients in group A were haemodynamically better than others groups and these wide ranges of values were due to large numbers of patients in group A than others groups. And wide range of associated injuries. This made the group A had the lowest score and better score.
As regard injury severity score (ISS), the minor were found in group A, moderate to sever were found mainly in group B while critical were found mainly in group C. ISS was increased with group C, then group B and then group A and most of patients of group A were minor ISS and most of patients in group C were critical.
The heart rates decrease after application of binder in three groups but values of decrease were more in group A then group B then group C .This decrease was due to analgesia, stabilization of pelvic fractures and stabilization of associated fractures which decrease the pain. Group C was statistically having higher values than other groups at different periods, because patients were shocked and there shock is refractory so they had reflex tachycardia.
The Mean arterial blood pressure in group A was statistically increased respectively at different periods than before application but the increase is so lightly because patients already vitally stable. In group B, the patients were shocked and the mean blood pressure was statistically increased respectively at different periods than before application. In group C, the Mean arterial blood pressure was statistically decreased respectively at different periods than before application, there were highly statistical significant differences between the studied groups regarding MABP, group A is statistically have higher values than other group because patients had stable pelvic fracture and haemodynamically stable than other groups. So the pelvic binders were effective mainly in group B.
The Respiratory rates were statistically decreased respectively at different periods than before application in all groups. There were highly statistical significant differences between the studied groups regarding respiratory rate, group C was statistically had higher values than others groups at different periods regarding respiratory rate. And these decreases in three groups were due to analgesia, stabilization of pelvic fractures and stabilization of associated fractures which decrease the pain.