Which initial management step is recommended for a suspected pelvic fracture?

• A. Begin rapid chest compressions to control bleeding
• B. Elevate the patient's legs to increase venous return
• C. Delay immobilization until hospital imaging
• D. Apply a pelvic binder to stabilize the pelvis and reduce bleeding; transport promptly.

Answer: (D)

Stabilizing the pelvis with a binder is the best initial step because pelvic fractures can bleed heavily into the pelvic cavity and surrounding tissues. A pelvic binder (or sheet) compresses the pelvis, reduces the pelvic volume, and limits movement, which helps control hemorrhage and supports circulation while you prepare for definitive care. This proactive stabilization is performed in the field as part of early trauma management, followed by rapid transport to a facility where definitive care can be provided.

Starting chest compressions is reserved for cardiac arrest and would not address the source of bleeding from a pelvic fracture. Elevating the legs is not a standard or beneficial intervention for pelvic bleeding and can delay proper stabilization. Delaying immobilization until hospital imaging misses the opportunity to minimize movement and ongoing bleeding in the prehospital setting.