Episode 24 - Hemodynamically Unstable Pelvic Fractures

The podcast explores the optimal management of hemodynamically unstable pelvic fractures, featuring Dr. Clay Cawthron Burlew, a trauma and acute care surgeon at Denver Health. Dr. Burlew discusses the evolution of their multidisciplinary approach, emphasizing the shift from angiography to preperitoneal packing combined with external fixation as the primary intervention. She highlights that venous and bony fracture-related bleeding are the main problem, not arterial bleeding. The conversation touches on the use of REBOA as a bridge to stabilize patients with severe pelvic fractures, incorporating it within a clearly defined algorithm. Dr. Burlew also addresses concerns about infection risks associated with pelvic packing, advocating for a single packing approach and good tissue debridement to minimize infectious morbidity.