In the severely injured patient, attention may be directed toward specific diagnostic measures, after immediate supportive efforts have been completed toward stabilization of the injured person's general condition. Discharge of blood from the urethral meatus or gross hematuria is the cardinal sign of damage to the urinary tract. Every person who has sustained injury to the bony pelvis or suprapubic region, and particularly everyone who has fractures of pubic rami, must be investigated for possible injury of the bladder or urethra. Injury to a structure of the urinary tract may be only part of a complex situation and as such demands consideration in proportion to its severity.
DeWeerd JH. CARE OF THE SEVERELY INJURED PATIENT-UROLOGIC ASPECTS. JAMA. 1957;165(15):1916–1921. doi:10.1001/jama.1957.02980330018005