T-pod for haemorrhagic control in Pelvic Trauma
Date First Published:
March 4, 2013
Last Updated:
March 4, 2013
Report by:
David Clarke, St5 In Emergency Medicine (Stepping Hill Hospital, Stockport, UK and Royal Manchester Children\'s Hospital, Manchester, UK)
Search checked by:
Michael Stewart, Stepping Hill Hospital, Stockport, UK and Royal Manchester Children\'s Hospital, Manchester, UK
Three-Part Question:
In [trauma patients with unstable pelvic fractures] is [pelvic immobilisation with a T-POD or pelvic immobilisation with a wrapped sheet] better [at haemorrhage control]?
Clinical Scenario:
A patient is brought to the Emergency Department with pelvic trauma. One of the members of the trauma team mentions that the new T-POD pelvic binder is better at controlling internal haemorrhage than the traditional wrapped sheet. You wonder if there is any evidence to support this?
Search Strategy:
Medline 1980 - May 2011 using the NHS library interface. [[Pelvis ti.ab OR Pelvic ti.ab] AND [Splint ti.ab. OR immobilisation ti.ab.] AND [Trauma ti.ab]] OR [Tpod ti.ab]
Medline 1980-February 7th 2013 using NHS Evidence
(TPOD ti,ab OR T-POD.ti,ab OR trauma pelvic orthotic device.ti, ab) = 13 records
Embase 1980-Feb 7th 2013
15 records no new relevancies
The Cochrane Library Issue 1 of 12 Jan 2013
TPOD ti,ab OR T-POD.ti,ab OR trauma pelvic orthotic device.ti, ab 2 records no new relevancies
Medline 1980-February 7th 2013 using NHS Evidence
(TPOD ti,ab OR T-POD.ti,ab OR trauma pelvic orthotic device.ti, ab) = 13 records
Embase 1980-Feb 7th 2013
15 records no new relevancies
The Cochrane Library Issue 1 of 12 Jan 2013
TPOD ti,ab OR T-POD.ti,ab OR trauma pelvic orthotic device.ti, ab 2 records no new relevancies
Outcome:
This search yielded 19 papers. No paper directly answered the question.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Effect of a new pelvic stabilizer (T-POD) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures. Tan ECTH, van Stigt SFL, van Vugt AB 2010 | 15 patients | Cohort |
Author Commentary:
The study by Tan et al, which showed an increase in MAP and a reduction in heart rate after the application of the T-POD, provides some evidence for a tamponnade effect and an arrest to further deterioration.
Bottom Line:
Insufficient evidence currently exists to recommend the T-POD over the traditional wrapped bed sheet. A large, prospective, randomised controlled study is required to assess the safety and efficacy of PCCD. Local guidelines should be followed?
References:
- Tan ECTH, van Stigt SFL, van Vugt AB. Effect of a new pelvic stabilizer (T-POD) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures.