Pitfalls

It’s important to know the mechanism of injury.
Clinical examination for pelvic injury is unreliable if patient GCS <15 or if there is a distracting injury.
On the contrary, if the patient is alert and awake, painless straight leg raise can be incorporated into initial examination to exclude pelvic fracture.
“Springing” of pelvis and log-rolling should not be done as blood clot can be dislodged causing haemodynamic instability.
The pelvic binder is frequently applied incorrectly and too high. It should be applied directly to the skin and at the level of the greater trochanter, which is lower than the trousers waistline and should be at a similar level to testicles for males. Too often the pelvic binder is applied on top of the clothes, which can cause pressure necrosis and impedes physical examination of the perineum area.
Forgetting to request a post binder removal pelvic x-ray. Pelvic binder can mask a pelvic fracture on CT or X-ray.