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So we have looked at pelvic injuries and actually how they occur. Now, we are going to actually have a look at how we can stabilise the pelvis and on this occasion, we are going to use a SAM pelvic sling. The SAM pelvic sling is a very, very useful part of our equipment, which has numerous parts to it. So we will run through the parts first. First of all, there is a pressure sensitive buckle. This buckle is designed so we cannot over-tighten or over-tensile the pelvis itself. So it is self-controlled pressure points. So as we pull the belt tight, it will stop you over-tightening it. There is a safety handle to hold whilst we tighten the sling up itself, there is a broad pad which gives us the actual pelvic support and stabilises the pelvis, the back has a slippery plastic surface to allow us to slide it behind the patient and slide it up and down the seat or whatever surface we need to, to be able to place it behind the patient easily. And then there is a velcro strap, which is the locking mechanism. And you will notice the velcro strap has holes at set intervals along the strap. And those holes are locating holes for the pressure sensitive buckle. When the two pins exit the buckle, they lock off onto the velcro sling and stop you over-tightening it and the velcro then locks back on itself and locks the pelvic sling in place.

Once this is inserted and applied, it gives us the best quality pelvic support whilst we extricate the patient from the car. So to apply the pelvic sling it needs to go and immobilise the pelvis itself and there are two ways of actually applying it. The first one is behind the knees and slide upwards, the second one is the hollow of the back and slides down. Whichever is the best for the casualty you are dealing with, whichever position they are sitting in, the easiest is obviously going to be the best. On this occasion, we are going to go from the knees then slide up behind the thighs. So two-person operation, one person on one side, one person on the other, and we then use a patient's clothing to actually slightly lift the patient. What we want to try and do is remove as much as possible any movement to the pelvis, but if we use clothing and work as a team, we should be able to lift the pressure slightly off the chair and allow the sling to slide gently underneath the patient's legs.

See-saw it. So in a see-sawing motion, we slide it up underneath the patient's pelvis.

And as soon as we come to level with the top of the pockets or basic the pelvis itself when we reach the right position, we then tighten off. First checks we need to make is there is nothing in the patient's pockets on either side because when we tighten the belt up we do not want the belt to squeeze contents of the pockets against the patient's skin, because it will hurt and cause pressure sores. So checking the pockets, and there is nothing in the pockets, and belts are also loose, so we are not pressing the belt into the waist at all, we then feed the strap across the patient's pelvis and we loop it through the pressure sensitive buckle. When it is through the pressure sensitive buckle, we then start to apply pressure nice and gently, nothing fast, nothing too hard, a gentle increase in pressure until the buckle locks. You can see the buckle will not allow me to go anywhere further than the buckle itself allows. At that point, we velcro the strap down and the buckle will then release, supporting the tops of the legs and the pelvis and giving it some support and structure.

Once the pelvic sling is in place, we will still always take the lower parts of the legs out of the equation as well, so we normally put a strap above the knees, below the knees, and a figure of 8 around the feet keeping the lower limbs stable, reducing flex of the pelvis, reducing any more damage or potential damage to bladder, internal organs and also reducing pelvic blood loss. So now we are going to have a look at applying a SAM pelvic sling to a patient that may have fallen out of a tree, or fallen from a height, fallen from a horse, but actually is on the surface on the ground. So on this occasion, we are going to place the pelvic sling through underneath the arch of the back and feed it down into position. So again, moving the arm out of the way, check that the arm is okay before we move it at all times, we feed the pelvic sling underneath the arch of the back using the arches to be able to get underneath the patient.

As soon as it comes through the other side, Mike will pull it until we get it central and then again, in a sliding motion whilst using the clothing to give us a little bit of support to the patient, it is slid into position. Got it? Once it is in position, we check the pockets to make sure there is nothing in the front or the back pockets before taking the strap across through the buckle, then the buckle is held while the pressure is applied. The buckle locks, the pins come through the strap, the strap is then velcroed back on itself, the buckle releases and the pelvis is stabilised and again, above, below and a figure of 8 around the knees giving stability to all the lower limbs, reducing any movement, any pressure or flexation of the pelvis.