This document provides guidance on the acute management of pelvic ring injuries. Key points include: 1. Pelvic ring injuries can cause significant hemorrhage and morbidity. Initial management focuses on airway, breathing, circulation and hemorrhage control through methods like pelvic sheeting, binding, or external fixation. 2. Indications for transfer include hemodynamic instability, bladder/urethra injury, open pelvic fractures, or significant displacement/instability on imaging. Physical exam assesses for injuries like degloving or limb deformities. 3. Sources of hemorrhage include external wounds, chest, long bones, abdomen, and retroperitoneum. Hemodynamic instability is evaluated through