Initially, advanced trauma life support (ATLS) protocol requires that airway, breathing, and circulation (ABC) to be maintained. Blood at the urethral meatus is an indication of lower urinary tract (bladder, urethra, penis) injury. Foley catheter should not be inserted until the integrity of urethra is assessed (usually by performing a retrograde urethrogram). Trauma x-ray panel includes a pelvic study to evaluate the extent of injury to pelvic brim and pubic symphysis. Fracture of the pubic rami or diastasis of pubic symphysis are commonly associated with dislocation of the sacroiliac joint as well as direct or indirect injury to the bladder and bulbous urethra.