What should the EMT's primary concern be for a patient with pelvic instability and pain after a motorcycle accident?

In the context of a patient presenting with pelvic instability and pain following a motorcycle accident, the primary concern should indeed be potential internal blood loss. Pelvic fractures can lead to significant hemorrhage, often due to the rich vascular supply in the pelvic region. When the pelvis is fractured or unstable, there is a high likelihood of major blood vessels being damaged, which can result in rapid internal bleeding.

This internal bleeding can be catastrophic because it may not be immediately visible externally, but it can lead to hypovolemic shock if not addressed quickly. Therefore, assessing the patient for signs of shock, monitoring vital signs closely, and being prepared to intervene with fluid resuscitation or other interventions is crucial in this scenario.

While spinal injury, pelvic fractures, and pelvic organ damage are all valid concerns in a motorcycle accident, the immediate threat to life from internal blood loss should take precedence in the assessment and management of the patient.