In this section
All children under 16 years of age with major trauma (including confirmed or highly suspected pelvic injury) should have ongoing management at Royal Children's Hospital. See
State Trauma Guidelines
In Victoria, the Paediatric Infant Perinatal Emergency Retrieval (PIPER) service is available to retrieve critically injured children from referral hospitals and provide safe, expert, emergency inter-hospital retrieval. The earlier contact is made with PIPER, the
earlier assistance can be dispatched to the hospital.
Major paediatric trauma
Massive transfusion procedure
Pelvic fractures are rare in children, but may occur in high-energy traumas.
Assessment of the pelvis occurs during the primary survey. Identification of major pelvic injury and the stabilisation of the pelvis should occur together at this stage.(see
Major paediatric trauma).
Key questions to answer early in the initial care of any child with a suspected or confirmed pelvic injury are:
What features of
the history make pelvic injury more likely?
Which features on
examination make pelvic injury more likely?
NB: Beware visceral injury: thorough examination for blood at the urethral meatus, vagina, scrotum, and rectum should be performed. If there is suspicion of a urological injury, please consult early with RCH Paediatric Urology.
Who needs a pelvic binder?
How do I apply a
pelvic binder to the patient?
Figure greater trochanter and symphysis pubic region
What if I don’t have a bespoke pelvic binder, or the child is too young?
For further information please watch “Technique for temporary pelvic stabilization after trauma” video from the New England Journal of Medicine available at
Who needs what pelvic
of pelvic trauma
When to consider transfer to a tertiary centre:
All paediatric major trauma patients (
<16 years old) need to be referred to the Royal Children’s Hospital in accordance with the Victorian State Trauma System.
Please consult PIPER 1300 137 650 early to ensure optimal advice regarding initial care and transfer to the Royal Children’s Hospital.
PIPER will facilitate discussion with the RCH ED, Orthopaedic +/- other surgical specialties re optimal early management.