Pelvic fracture-related arterial bleeding (PFRAB) can result in hemodynamic instability. Toth et al identified findings in the Emergency Department which can help to identify a patient with PFRAB. The authors are from John Hunter Hospital and University of Newcastle in New South Wales, Australia.

Patient selection: trauma with pelvic fracture

Predictors for pelvic fracture related arterial bleeding:

(1) base deficit >= 6 mmol/L

(2) change in base deficit over 4 hours > 2 mmol/L (worsening of the acidosis)

(3) systolic blood pressure < 104 mm Hg

(4) need for transfusion in the Emergency Department



The change in base deficits is (initial base excess) - (second base excess)



(1) exclude chest, abdominal and extremity bleeding

(2) triage a trauma patient with these risk factors for pelvic hemorrhage control (angiography, pelvic packing)



The area under the ROC curve is 0.77.

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