ambivalent. Really you’re only stabilising with the binder - management is as per the original card. Your uworld text is referring to haemodynamically unstable patients rather than unstable fractures (though it’s a little silly - you’re still going to apply a binder if they’re haemodynamically stable!!) - and real-world, you’re likely to be applying a binder to anyone with high mechanism pelvic trauma.
Agree with Joe. Can someone confirm whether this is the correct answer? or if the question should just say “best next step”
Tintinalli EM study guide 9e p1840-1841 states binder for haemodynamically unstable pelvic # (unless where lateral compression # suspected). I can confirm that pre-hospitally any potential pelvic # will be getting a pelvic binder (so as these patients are unlikely to self-present, the vast majority will already have one in place, haemodynamically unstable or not). One exception is elderly fallers, who perhaps may not get one (e.g. #NOF most likely and pelvic binder likely to worsen pain). Even the text itself in the extra uses the qualifier ‘haemodynamically’ not unstable pelvic fractures in general.
Thought about it and I agree. Angiography is not always indicated, occasionally laparotomy is. This issue is much more complicated than this question leads on - FAST scan needs to be done to determine if laparotomy is indicated. It sounds like stabilization is always done, so I think that is appropriate to change this card, and we can let practice Qs guide subsequent changes