Two methods of Improvising a Pelvic Splint
21st January 2013, revised 27th July 2018 and 9th May 2019
When a proprietary Pelvic Splint is not available, an effective device can be made.
There are mixed reviews over the efficacy of improvised Pelvic Splint with a bed sheet being the most cited example. (1). One of the techniques shown here utilises a foil blanket which overcomes the practical impediments of a large, bulky bed sheet which account for its lack of efficacy.
It is, however, elsewhere cited that an improvised device is more readily available, costs less, is more versatile, and is equally as efficacious at immobilizing the unstable pelvis as compared to proprietary devises and their usage should be encouraged. (2-4)
Prior to reading this, we strongly recommend you read the accompanying article Pelvic Injury, especially regarding the application of a pelvic splint.
Method 1: Tourniquets and a SAM splint
What you need:
2 x tourniquets
Having used this method in various training scenarios, it’s benefit is that it can be made relatively quickly with materials that would commonly be found in a remote first aid kit or medical bag but there are a couple of drawbacks to this method:
Because of muscle-memory, there is a tendency to over-tighten the tourniquets as if they were being applied to arrest a catastrophic haemorrhage.
Tourniquets are an important item of equipment if your Needs Analysis suggests they should be in your medical kit. Really, they should be preserved for their primary purpose.
This design can slip from the optimum position at the greater trochanters more easily than Method 2.
Method 2: Foil Blanket
What you need:
A triangular bandage or alternative
Combined with the ankles tied together, you have effectively stabilised you pelvic casualty ready for transport.
Sinha S, Ellicott H, Gee E and Steel A. (2015). “A bed sheet is not as effective as a pelvic circumferential compression device in generating pelvic compression in patients with a suspected pelvic fracture”. Trauma. 17. 128-133.
Prasarn ML, Conrad B, Small J, Horodyski M, Rechtine GR. (2013) “Comparison of circumferential pelvic sheeting versus the T-POD on unstable pelvic injuries: A cadaveric study of stability”. Injury. 44. 1756–1759
Shackelford S, Hammesfahr R, Morissette D, Montgomery HR, Kerr W, Broussard M, Bennett BL, Dorlac WC, Bree S, Butler FK. (2017) “The Use of Pelvic Binders in Tactical Combat Casualty Care: TCCC Guidelines Change 1602 7 November 2016”. Journal of Special Operations Medicine. 17(1):135-147.
Schaller TM, Sims S, Maxian T. (2005) “Skin breakdown following circumferential pelvic antishock sheeting: a case report”. Journal of Orthopaedic Trauma. 19:661–665.