Comparing fixation pressure and operator proficiency in the use of pelvic binders: a study of the SAM Pelvic Sling II and AP MAX Truncal Orthosis

Pelvic fractures are associated with high morbidity and mortality and often require immediate stabilisation. Pelvic binders help control haemorrhage; however, variations in design and operator proficiency may affect performance. This study compares the SAM Pelvic Sling II and AP MAX Truncal Orthosis in terms of pressure application and consistency. Thirty emergency nurses applied each binder twice on a human truncal dummy model, yielding four pressure measurements per operator: SAM first trial, SAM second trial, AP MAX first trial, and AP MAX second trial. The applied pressure was measured using a water column system. Paired t-tests were used for prespecified within-operator comparisons after assessing the normality of paired differences. A linear mixed-effects model with operator ID as a random intercept was used to evaluate the effects of device type, trial, and operator experience on fixation pressure. Both binders showed significantly higher fixation pressure in the second trial (SAM, p = .007; AP MAX, p < .001). The mixed-effects model showed a significant trial effect (χ²(2) = 10.11, p = .006), whereas device type (p = .231), the device-by-trial interaction (p = .506), and operator experience (p = .554) were not significant. Both binders generated comparable fixation pressures in this experimental model. As the AP MAX produced fixation pressures similar to those of the SAM Pelvic Sling II, it may represent a lower-cost option for producing similar pelvic compression; however, its clinical efficacy was not evaluated and requires further investigation.