Date: Sun, 19 Jan 2003 18:12:16 +0530

Subject: Circumferential Pelvic Antishock Sheeting

I have just read this article  titled "Circumferential Pelvic Antishock Sheeting: A Temporary Resuscitation Aid " published  in JOURNAL OF ORTHOPAEDIC TRAUMA 2002;16:45-48 by Chip Routt et al. I was quite impressed with this simple technique which can be practiced world over by those who are aware of this simple technique.   I will be happy to know first hand information on their experience from people who would have tried this on their patients. How good is this method to transfer patients. We have this problem in this country where patients need be transferred long distance in far from ideal conditions.

Dr.T.I. George, Consultant Orthopaedic Surgeon,
Polytrauma, Microvascular Surgery And Hand Surgery Unit,
Metropolitan Hospital, Trichur, S.India.

Date: Sun, 19 Jan 2003 10:23 EST

From: Bill Burman

Dr. George

There was some discussion of antishock pelvic binders at the OTA-AAST 2000 Pelvic Injury Symposium.

Bill Burman, MD
HWB Foundation

Date: Mon, 20 Jan 2003 17:25:31 +0530

From: DR T I GEORGE

Thanks a lot Dr Bill Burman.

That was a useful link. I am in the process of reading through the whole symposium proceedings.

In the mean time is this measure of "Circumferential Pelvic Antishock Sheeting" recommended for application by the paramedics in your country or any other country before the patient is transferred from the accident site or during transfer ?

DR T I GEORGE

Date: Mon, 20 Jan 2003 08:11:58 -0500

From: James Carr

TI

I have not used the sheet for interfacility transfer, but we do use it all the time in the ER. Great idea. I think it is best applied with some type of clamp to secure the sheet. We occasionally get someone who thinks to tie a knot rather than use a clamp - this is bulky and intrusive. I think the long term concerns would be things such as abdominal compartment syndrome. However, if someone responds with good hemodynamics, I would say leave it on with en route monitoring.

James B. Carr, MD
Palmetto Health Orthopedics

Date: Mon, 20 Jan 2003 05:56:56 -0800

From: Chip Routt

Sheets are readily available, inexpensive, disposable if heavily soiled, easy to apply, reliably maintain reduction, and can be cut strategically so that angiography can proceed or iliac external fixation pins (or other percutaneous pelvic implants) can be applied/inserted before removing the "reduction sheet".

The sheet can worsen lateral compression pelvic injury pattern's deformity and should be applied with care in those patients.

The sheet contact with the skin should remain taut and smooth.

Clamps should be used to secure the sheet, and the extra fabric material can be cut away if you choose.

If properly applied, they are perfect for early use, even for patient transport.

M.L. Chip Routt, Jr.,M.D.
Professor-Orthopedic Surgery
Harborview Medical Center
Seattle, WA 98104-2499