Why are MAST/PASG Bad?

[Alkalinefood]

Just curious as to why military anti shocks trousers and
pneumatic anti shock garmets are bad?

I didn't catch the reasons.

What are the reason for each of them? I know theres a bnuch if you can same all you know that be cool...

does anyone know in thre first place? thanks
~Jb

 

[KEVD18]

the drawbacks of mast use outweigh the benefits. they have a complicated list of contras. they increase scene times, have little positive effect on the pt's outcome and in many cases, has a negative impact on pt outcome.

 

[BloodNGlory02]

They arent neccessarly bad. I've used them once and they were actually very helpful. You just have to be 100% in your assesment if you're considering them. Some reasons they might be "bad" are once you inflate them, generally you dont deflate them in the field (risk of PE) you have to know all contraindications (altho we were told in school the only 100% contra is COPD), and you need to monitor your patient Q 3-5 minutes with them inflated.

 

[Ridryder911]

The reason for not using PASG is it does actually cause some increasing in blood pressure, (remember we may NOT want to increase the B/P it causes the hole to get bigger= increase bleeding= increase shock). As well, as compression on tissues causes acidosis, and poor tissue circulation as well as fragmented clots to be released.

The only absolute contraindication is pulmonary edema, (CHF). Other than of course hypertension. Considerations of not placing them are injuries above the level of PASG, 3'rd trimester pregnancy, and of course no inflation of abdominal compartment w/evisceration

I use PASG for about 15 years, and seen them work; however we became more educated in proper placement and inflation procedures. We never inflated until "pop valved" worked, and never increased pressure above 80mm/hg systolic. They were only utilized to increase coronary and cerebral perfusion, and increase some systolic resistance so IV cannulation would be easier.

We were never foolish thinking "they would stop or treat shock".. and yes, they were and are only very little temporary.

The dangers of removing them is "sudden death".. Ripping them off causes a massive release of acidosis and platelet debris into the system. Imagine a compression to be suddenly released, and the blood flow from it. I have seen patients die from improper removal of PASG, from nurses and physicians alike. The deflation procedure usually takes a minimum of 15 -30 minutes.. and yes, they should be in surgery.

Again, the philosophy and treatment of shock is and continues to radically change. We DO NOT want to raise the blood pressure very much. Increasing blood pressures causes increased hemmorraging. As well as possible internal wound size.

Research from Vietnam, revealed those that was not aggressively treated had better outcomes than those that did.... hence, the body goes into a homeostasis area to take care of itself.

Yes, PASG works varely rarely and not enough to warrant to be placed into treatment regime. Yes, several research has proven and demonstrated they do not work effective enough to outweigh the risks.

R/r 911

 

[Jon]

First, Alkaline... Welcome to EMTLife.

Just to clarify - MAST/PASG are the same thing... MAST was the military acronym, PASG is the civilian version... or so I've been told.

as R/R already pretty much covered... MAST is good at making a patient "look better" for a short amount of time. The patient has more blood to pump and less area to pump the blood, because they have almost no bloodflow to their legs. Their blood pressure comes up and they look less "shocky" but it is a "show"... they are in deeper doo-doo... they've got the metabolic acidosis building up in their legs, similar to "Crush Syndrome." They also have more blood running through the system to pump out whatever holes are causing the problem in the first place.

MAST are no longer indicated for shock. They are still "supposed to be" useful as air splints for leg fractures or hip fractures, but that all depends on local protocol.


Oh, and about contraidications - one I was told is that the abdomen section is left off if they are pregnant.