Protocol:
Trauma Pelvic Orthotic Device (T-POD). A 2 part device - fabric belt and a plastic/velcro mechanical advantage pulley system (power unit).

Use: Adults and Children

Outcome:

1. Lower mortality rate.
2. Aid in pain management.
3. Provide a quick, safe, and effective method in initial trauma resuscitation of an open-book pelvic fracture.

Content:

1. Indication- Used in the initial treatment to stabilize a suspected or diagnosed pelvic fracture to help decrease blood loss and aid in pain control. The T-POD is a temporary device until definitive treatment can be accomplished.
   


2. Initial Assessment-
   
   a. Assess for abrasions and contusions around the pelvic area.
   b. Assess for superficial hematoma above inguinal ligament, scrotum, and thigh.
   c. Assess limb length discrepancy and deformity.
   d. Assess pelvic stability by bimanual compression of the iliac wings.
   e. Examinations of the rectal and vaginal areas for bleeding.
   


3. Application- The T-POD should be placed by trained healthcare provider. Wrap the fabric belt around the supine patient. Fit the T-POD around the pelvis at the level of the greater trochanters (ideally the belt should cover the buttocks). Then cut excess belt in front leaving a 6-8 inch gap of exposed abdomen. Apply pulley system/power unit to each side of the belt and slowly pull tension until snug. This provides simultaneous circumferential compression of the pelvic region. This should aid in pain control and vital sign improvement (note: in male patients make certain genitalia are elevated out of groin area). A healthcare provider should be able to insert two fingers between the patient and the T-POD. Person applying the T-POD should document time and date device is applied in space provided.

1. If an obese patient requires the T-POD, two belts may be affixed together using one power unit as an extender/linker and the other as the pulley.
2. Monitor pulse and blood pressure q 15 minutes or per your individual department protocol.
3. If T-POD remains on the patient longer than 24 hours, skin integrity should be checked and evaluated every 12 hours.
4. Place Foley prior to application as needed.
5. Children under 50 lbs (23 Kg) may be too small to obtain the 6 inch gap needed for closure.