# Is PASG for Basic Shock Treament used anymore?



## Dutchieee (Sep 13, 2015)

During my classes. We only discussed the use of the PASG. And we never really went over using it. 
or seeing it for that matter. I even get practice questions on it. (Still looking to know about it because well, you never really know.)

So as the question states, is it still used today in some states/counties?


----------



## NomadicMedic (Sep 13, 2015)

Nope. They've fallen out of favor. But, like many things in EMS, give it time and they'll be back in vogue. 

Although, I think Rhode Island still has them on the truck, along with EOAs.


----------



## Martyn (Sep 13, 2015)

I believe Polk County, FL still have them as well...but not used anymore.


----------



## TransportJockey (Sep 13, 2015)

Martyn said:


> I believe Polk County, FL still have them as well...but not used anymore.


That's odd for a system like them.  I know winter haven took them off a couple years ago


----------



## Martyn (Sep 13, 2015)

They may well have done, I remember them on the trucks though (albeit a while ago admittedly).


----------



## EpiEMS (Sep 13, 2015)

Dutchieee said:


> During my classes. We only discussed the use of the PASG. And we never really went over using it.
> or seeing it for that matter. I even get practice questions on it. (Still looking to know about it because well, you never really know.)
> 
> So as the question states, is it still used today in some states/counties?



We carry them in Connecticut, but they're not in use...

The evidence in favor of use of the MAST/PASG was pretty weak to begin with (see this study). It was thought that the inflated pants would "autotransfuse" blood from the lower extremities to the head and torso (among a handful of other beneficial effects, some of which are...debatably valid, like applying pressure to otherwise uncontrolled hemorrhage in the lower extremities or acting as a binder for a pelvic fracture). On the other hand, evidence is weak that this actually occurred: Cochrane Reviews showed increased incidence of adverse outcomes, and the NAEMSP review of the literature from 1997 showed (mainly) negative impact of use. Plus, it never really did "autotransfuse" the promised amount of blood...something like 300ml in the average 80kg adult male versus promised 1000ml. 

Another fun quote: "[N]o clinical trials had ever proven its effectiveness in saving lives. Empirically, it made sense to use the PASG, but subsequent prospective controlled trials not only disproved the ability of the PASG to save lives, but also suggested the devices were actually detrimental."

To wrap up, I'll leave the overview to the good Dr. Bledsoe:

"MAST are a relic of our past and belong in EMS museums, not on modern ambulances or rescue vehicles."


----------



## Martyn (Sep 16, 2015)

Just as an aside I started with a BLS IFT company a couple of weeks ago, MAST is still on the PCS (paper one) although we don't carry it


----------



## Tigger (Sep 18, 2015)

When I started here two years ago we still had them on the ambulances. Not for use, but to use the box for trendelenburg, which also has little evidence for (especially considering EMS practical limitations). One day I made them go away, no one has mentioned it.


----------



## CALEMT (Sep 18, 2015)

Ive never seen them out here in the 3 years I've been a EMT. We only talked about them in school and never used them, if I saw one I highly doubt I would be able to use if effectively.


----------



## PotatoMedic (Sep 18, 2015)

Pierce county Washington still has them.


----------



## over seijasw (Sep 19, 2015)

When I was in Emt school my instructor ways told us to know it in and out because u can get it as a question... But we don't use them. But always good to know it


----------



## MackTheKnife (Sep 19, 2015)

Without trying to start a firestorm, here goes: In the '80's (yes, prehistoric EMS era), MAST was taught, carried and used. I personally used them three times with two trauma victims and one victim suspected of a ruptured/rupturing abdominal aneurysm. In all three cases, after 1-2L of Ringers, and no real improvement in vitals/perfusion, the trousers were applied and vitals/perfusion improved significantly. Why did we use them?  Mainly due to a long transport time in addition to the IV. For those that want to jump and say that this is not evidenced-based,, you are correct- it's anecdotal.


----------



## Bullets (Sep 24, 2015)

I was always under the impression that they really only show a benefit in long distance ground transports to trauma centers. So for like me, the trauma center is in my town, and MAST doesnt make sense. Few spots in NJ really have long transports. Though i have used it on an pelvic fracture, just the upper part. Seemed to provide some pain relief to the patient.


----------



## Smitty213 (Sep 26, 2015)

NY still touches on it in class, and then says don't use them. That being said, there is a region or two where the vollies still carry them, though I have a feeling that will change with the new state wide collaborative protocols.


----------



## DSDMedic (Jul 5, 2016)

I can tell you that they're outside of scope for everyone (including medics) in Georgia now. We covered them in class, very briefly, but I don't think a single student from my current Basic class would have a clue about how to apply them. I originally did my EMT in CO in the late 90's, before leaving the field and letting my certs go (stupid me!), and we learned them then and actively used them due to long transport times.

And I just realized that this is a 10-month old thread. Woops. Teach me to post when tired.


----------



## MackTheKnife (Jul 6, 2016)

Yep, it's an old post but that's ok. I'll jump on board with this: PASG/MAST work. I used them a lot in the past.

Sent from my XT1585 using Tapatalk


----------



## Summit (Jul 6, 2016)

Discussed in class on 04 and even had on the bus but no protocol or thought of use


----------



## EpiEMS (Jul 6, 2016)

Finally took them out of the bus in CT!


----------



## NomadicMedic (Jul 6, 2016)

EpiEMS said:


> Finally took them out of the bus in CT!



I took my EMT way back when in CT. (At the Coventry fire house, thank you very much) We trained on MAST and used em a couple of times.


----------



## EpiEMS (Jul 6, 2016)

DEmedic said:


> I took my EMT way back when in CT. (At the Coventry fire house, thank you very much) We trained on MAST and used em a couple of times.


It's crazy how backwards CT is.
We still maintain -- effectively -- IV-only "A"EMTs...for example.

Then again, no more backboards...so, that's something. 

On MAST, I'd be very curious if there's any research on their use as a pelvic splint -- especially in contrast to a sheet or a SAM pelvic sling.


----------



## DSDMedic (Jul 7, 2016)

EpiEMS said:


> On MAST, I'd be very curious if there's any research on their use as a pelvic splint -- especially in contrast to a sheet or a SAM pelvic sling.



I can't speak to research specifically, but by the time I left the field that was what we were using them for more often than anything else. Anecdotally at least they seemed to make effective pelvic splints, and were better for our long transport times than messing with sheets.


----------



## EpiEMS (Jul 7, 2016)

DSDPhoto said:


> I can't speak to research specifically, but by the time I left the field that was what we were using them for more often than anything else. Anecdotally at least they seemed to make effective pelvic splints, and were better for our long transport times than messing with sheets.


Seems reasonable to me. I guess anything that would provide more uniform, consistent circumfirential pressure than a sheet is an improvement. 
Then again, I've never seen a true pelvic fracture, myself, just played with sheets and SAM pelvic slings.


----------



## Tigger (Jul 8, 2016)

EpiEMS said:


> Seems reasonable to me. I guess anything that would provide more uniform, consistent circumfirential pressure than a sheet is an improvement.
> Then again, I've never seen a true pelvic fracture, myself, just played with sheets and SAM pelvic slings.


Sheets suck. I'm told a KED is an effective solution (upside down).


----------



## Summit (Jul 8, 2016)

Tigger said:


> Sheets suck. I'm told a KED is an effective solution (upside down).


I trained on this solution as a better choice than a sheet. Now we have the SAM solution.


----------



## Tigger (Jul 8, 2016)

Summit said:


> I trained on this solution as a better choice than a sheet. Now we have the SAM solution.


Incidentally I just went downstairs and we now have SAM pelvic binders that were somehow donated to us in great quantity. Sweet.


----------



## sack jears (Jul 11, 2016)

We were taught application of them in our basic class, although the instructor wouldn't alllow us to inflate them on our peers in fear it would break clots in our legs and trigger a pulmonary embolism


----------



## EpiEMS (Jul 13, 2016)

Tigger said:


> Incidentally I just went downstairs and we now have SAM pelvic binders that were somehow donated to us in great quantity. Sweet.


I'm quite jealous! I've trained on the SAMs, and they are easy to use.


----------



## vc85 (Jul 16, 2016)

Theoretically they are still in protocol for us. But it's a "if the planets align and you spin around three times maybe you will be allowed to use them protocol". I know the BP needs to be extremely low like below 80/50 as one of the criteria

Our EMT instructor though believed they should be back in protocol and insists they were taken out because of one doctor in Texas who had some sort of personal vendetta against MAST trousers and admitted to doing bad research


----------



## MackTheKnife (Jul 18, 2016)

sack jears said:


> We were taught application of them in our basic class, although the instructor wouldn't alllow us to inflate them on our peers in fear it would break clots in our legs and trigger a pulmonary embolism


Your instructor is ignorant of the facts.

Sent from my XT1585 using Tapatalk


----------



## MackTheKnife (Jul 18, 2016)

MAST trousers work. I know, I used them a lot. In a galaxy, far, far away.

Sent from my XT1585 using Tapatalk


----------



## sack jears (Jul 19, 2016)

MackTheKnife said:


> Your instructor is ignorant of the facts.
> 
> Sent from my XT1585 using Tapatalk


My instructor is the most benificial person in my ems career and a fantastic medic and I most likely misinterpreted what he said. I'm probably the one ignorant of the facts but I won't have anyone talk down about that man


----------



## luke_31 (Jul 19, 2016)

sack jears said:


> My instructor is the most benificial person in my ems career and a fantastic medic and I most likely misinterpreted what he said. I'm probably the one ignorant of the facts but I won't have anyone talk down about that man


Wait until you have had a few instructors, you will really start to see who the quality ones are. There are a lot of instructors in EMT and paramedic schools that sound great until you get exposed to truly great ones. I've had the pleasure of both ends of the spectrum and once you've seen the two ends you really appreciate the knowledgeable ones.


----------



## sack jears (Jul 19, 2016)

luke_31 said:


> Wait until you have had a few instructors, you will really start to see who the quality ones are. There are a lot of instructors in EMT and paramedic schools that sound great until you get exposed to truly great ones. I've had the pleasure of both ends of the spectrum and once you've seen the two ends you really appreciate the knowledgeable ones.


Fair enough


----------

