A treatment plan for rapid assessment of the patient with massive blood loss and pelvic fractures.

Exsanguinating retroperitoneal hemorrhage secondary to pelvic fractures is a frequent cause of death in the injured pedestrian. Attempts at lowering the mortality from these injuries have led to a variety of suggested treatment modalities, including observation, arterial ligation, or direct suturing of the bleeding sites. Arteriographic embolization is perhaps the newest modality but requires implementation of a rapid and efficient triage and treatment plan. Each of the suggested modalities and the formulation of such a treatment plan are discussed and a case report showing the feasibility of immediate arteriographic embolization as the preferred mode of management is presented.