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August 1978

A Treatment Plan for Rapid Assessment of the Patient With Massive Blood Loss and Pelvic Fractures

Author Affiliations

From the Department of Surgery, University of California at Los Angeles School of Medicine, Los Angeles. Dr McAvoy is now at the University of Colorado School of Medicine.

Arch Surg. 1978;113(8):986-990. doi:10.1001/archsurg.1978.01370200080015

• Exsanguinating retroperitoneal hemorrhage secondary to pelvic fractures is a frequent cause of death in the injured pedestrian. Attempts at lowering the mortality from these injuries have led to a variety of suggested treatment modalities, including observation, arterial ligation, or direct suturing of the bleeding sites. Arteriographic embolization is perhaps the newest modality but requires implementation of a rapid and efficient triage and treatment plan. Each of the suggested modalities and the formulation of such a treatment plan are discussed and a case report showing the feasibility of immediate arteriographic embolization as the preferred mode of management is presented.

(Arch Surg 113:986-990, 1978)