https://stream.echo6.co/videos/watch/337c684d-e438-4c25-a169-283c606f36f3 In this episode of the PFC Podcast, Dennis is joined by Dr. Brigham Au, a 10-year orthopedic trauma surgeon, for a no-fluff masterclass on pelvic fractures. From high-energy MVCs and falls to sneaky low-energy geriatric injuries, Dr. Au breaks down exactly what matters in the prehospital/prolonged field care environment: stability, pain control, binders, and what actually saves lives. Whether you’re a combat medic, critical care paramedic, or wilderness provider, this is the episode that turns pelvic fractures from “scary” to “manageable.” Takeaways Physical exam beats imaging every time in the field. Gross manipulation is overrated; gentle leg positioning and pain response tell you more than you think. Pelvic binders WORK. Institutional protocols using them early cut mortality in half. Stop quoting tiny European studies, read the full papers. Simple field hack: Pull both ankles together, internally rotate, and secure the legs (sheet, belt, ACE wrap, buddy-tape style). Uses the good leg to splint the bad one and dramatically cuts pain during movement. Don’t hesitate if you even suspect an unstable pelvis (or the patient is hemodynamically unstable), slap the binder on tight over the greater trochanters. Life over skin necrosis in the first 24–48 hours. Geriatric ground-level falls are DEADLY higher mortality than many gunshots once they decompensate. Treat them like the sickest patient in the room. Read beyond the abstract. Small studies make for great Instagram soundbites but terrible clinical decisions.Improvised binders? Belt around the trochanters, cut pant legs, or a rolled sheet, just get it low and tight. Patient comfort during movement is your best feedback. The cowboy with the 20–30-year-old open-book pelvis whose plates kept breaking because “his pelvis didn’t want to close.” Why Dr. Au stopped doing aggressive stress exams after the 8-pound ankle test story. Why binders should be first-line, not optional, and exactly when/how to loosen them in austere environments. Brutal reality check on geriatric pelvic fracture mortality vs. modern gunshot wounds. Chapters 00:00 Welcome & Dr. Brigham Au intro (Parkland + trauma fellowship) 01:27 High-energy vs. low-energy pelvic fractures (what you’re actually seeing) 02:40 Open book, closed book, lateral compression, vertical shear, why mechanism still matters 04:31 Field assessment & why physical exam is king 06:25 Yes, patients can still walk with a pelvic fracture (don’t get fooled) 08:02 What “gross manipulation” actually means (and how little you need to do) 11:51 Leg-positioning trick that reduces pain and acts like a temporary binder 14:31 The pelvic binder debate: evidence, myths, and why Dr. Au is a huge believer 20:08 Improvised binders, proper placement & tension (even without a commercial device) 23:41 When and how to loosen or remove a binder (especially in prolonged care) 25:43 One thing Dr. Au wants every field provider to do better 28:17 Real risks of binders (and why you still shouldn’t hesitate) 29:27 Final thoughts + why reading full studies matters For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠ Wed, 22 Apr 2026 04:33:31 GMT https://validator.w3.org/feed/docs/rss2.html PeerTube - https://stream.echo6.co https://stream.echo6.co/client/assets/images/icons/icon-512x512.png https://stream.echo6.co/videos/watch/337c684d-e438-4c25-a169-283c606f36f3 All rights reserved, unless otherwise specified in the terms specified at https://stream.echo6.co/about and potential licenses granted by each content's rightholder.