In the field, how should bleeding from the groin or pelvis be managed?

• A. Apply a pelvic binder and control bleeding with direct pressure or hemostatic dressings; call for MTP
• B. Elevate the limb and apply a tourniquet
• C. Apply ice packs and await transport
• D. Ignore and proceed to transport immediately

Answer: (A)

The important idea is rapid stabilization of the pelvis combined with direct control of any external groin bleeding, plus activating rapid blood replacement if needed. Pelvic fractures often bleed from venous structures and fracture surfaces that aren’t easily stopped with a tourniquet. A pelvic binder tightens the pelvis, reduces pelvic volume, and helps tamponade bleeding, buy time for transport. At the same time, applying direct pressure to any visible groin wound or using a hemostatic dressing is essential to control actively bleeding surfaces in the area. Because pelvic hemorrhage can become life-threatening quickly, calling for rapid blood products through a Massive Transfusion Protocol ensures the patient receives necessary resuscitation without delay.

Elevating a limb and using a tourniquet targets limb bleeding and isn’t effective for pelvic hemorrhage. Ice packs and waiting for transport delay care in a situation that may require emergent intervention. Ignoring the problem isn’t appropriate in the field.