Good day Alesha,
This patient presents with a variety of concerns related to their injuries. In this particular case as presented, my top concern/priority would be focused on the potential blood loss into the internal spaces of the body where those injuries occurred. Femur and pelvic Fx can result in a great amount of blood loss and those cavities can contain quite a bit of the circulating volume. Additionally, since there are rib Fx, we also need to be vigilant about our ABCs and monitor for s/s of flail chest, pneumo/hemothorax, and the need for oxygen related the pain and inability to maintain adequate tidal volume.
For stabilization, we need to look at splinting all of the injuries. With the pelvis Fx traction splinting would be out for the femur Fx. There are a variety of pelvic binders and splinting options for that injury and then the femur Fx would need to be splinted as well. The rib Fx there is not much we can do, but if it is flail we would want to consider positive pressure ventilation, especially if breathing starts to deteriorate. Lastly, we need to take c-spine precautions due to the MOI along with be mindful of the soft tissue injury that will eventually need to be cleaned, treated, and bandaged down the road.
Obviously the answer is not all inclusive and still has several other areas that should be discussed, but hopefully that gets you in the direction you are looking for.
