What is the patient’s hemodynamic status? (Intrapelvic hemorrhage in these injuries can be fatal.)

Are there any open injuries? A pelvic and rectal exam must be performed to rule out vaginal/rectal open fractures.

What are the associated injuries?

CT scan with fine cuts through the pelvis

CT scan of the spine

Open fractures – open fractures carry a very high morbidity and should receive immediate antibiotics, urgent operative debridement, and possible diversion by a general surgeon if the wound communicates with bowel.

Neurovascular compromise – this needs to be communicated to the operative surgeon on call and, in the setting of vascular injury, the vascular surgery team as well.

Hemodynamic compromise – again, these injuries are frequently seen with intra-abdominal injuries and closed head injuries that need urgent attention when causing hemodynamic compromise.