In the setting of a pelvic fracture with hypotension, the recommended immobilization step is to apply a pelvic binder.

• A. Apply a pelvic binder
• B. Apply a backboard and immobilize entire spine
• C. Use leg elevation only
• D. Provide warm blankets

Answer: (A)

Stabilizing a patient with a suspected pelvic fracture and low blood pressure hinges on quickly controlling pelvic bleeding and stabilizing the pelvis. The fastest and most effective way to do this is by applying a pelvic binder. The binder compresses the pelvis, reduces pelvic volume, and helps tamponade venous bleeding from pelvic fractures, which can significantly improve hemodynamics and buy time until definitive bleeding control is achieved.

A backboard with full spinal immobilization targets the spine, not the bleeding that drives hypotension in a pelvic fracture. While spinal precautions can be important if a spinal injury is suspected, immobilizing the entire spine in this scenario does not address the critical issue of pelvic hemorrhage and can delay applying the binder.

Leg elevation alone does not control pelvic bleeding and thus does not resolve the life-threatening problem here. Warm blankets provide comfort and warmth but do not stabilize the pelvis or reduce hemorrhage.

So, applying a pelvic binder is the best immediate action to control bleeding and stabilize the patient in this situation.