For a 45-year-old patient who has fallen 6 meters and presents with GCS 12 and pelvic instability, what is the sequence of treatment?

In the scenario of a 45-year-old patient who has fallen from a height of 6 meters and presents with a Glasgow Coma Scale (GCS) of 12 along with pelvic instability, the priority in treatment is to manage the potential hemorrhagic shock that could arise from the pelvic injuries.

Applying a pelvic binder is crucial in this situation because it helps to stabilize the pelvis, reducing the volume of the pelvic cavity and potentially controlling internal bleeding. By compressing the pelvis, a binder can significantly decrease the risk of further hemorrhage and provide necessary stabilization to the patient, which is essential given the mechanism of injury and the patient’s instability.

Following the application of the pelvic binder, intravenous fluids can be administered to help maintain perfusion and support the patient’s hemodynamic status. This step is also vital, particularly if there is evidence or suspicion of significant blood loss.

The sequence of using a pelvic binder first, followed by fluid resuscitation, reflects best practices in pre-hospital trauma care for managing pelvic injuries. This approach effectively addresses life-threatening conditions and stabilizes the patient for further treatment and transport to an appropriate medical facility.