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  1. #1
    Join Date
    Dec 2001
    Location
    New York State
    Posts
    1,784

    Question MAST/PASG/G-SUITS, still viable?

    This will definitely label me as a dinosaur, but I still like MAST pants. I've read all the clinical trials (there weren't that many) and I've also used them in the field many times. At least in my mind, they may not always be 1st line treatment, but they are a valuable resource. Interestingly the 4 most touted studies showing poor outcomes with PASG were all conducted in urban areas with multiple Level 1 trauma centers and transport times under 10 minutes and almost universal access to pre-hospital ALS units. I agree completely. In that setting, a heavy right foot and surgeons will likely save more lives than anything we do as EMS providers. But what about where ALS isn't immediately available, if at all? What about areas where transport times can be 30-60 minutes or more? These are some of the scenarios where PASG can and will continue to save lives, if it is allowed. NYS BLS protocols still list PASG but severely restrict the indications for use and have greatly increased the contraindications. Combine this with the fact that they are no longer mandatory equipment on ambulances, and it is obvious their days are likely numbered. Even I, a proponent, have not had a need to apply PASG in several years.

    What brought about my inquiry today was the discovery of a relatively new anti-shock garment; the NON-pneumatic version or NASG. This consists of a lower body suit with strong velcro closures very similar to MAST/PASG but instead of using air pressure, the suit constricts due to it being made of neoprene. When the velcro is closed tightly, the inherent elasticity of the neoprene provides the compression. While not able to create the same pressures as PASG, these lower pressures seem to be producing similar results and may have fewer down sides? So far the only trials I've found have been in the use of NASG for uncontrolled obstetrical post-partum bleeding. Does anyone know of an EMS system using or evaluating this new anti-shock garment?

    Many things have changed in shock resuscitation over the years. We no longer make our patients bleed pink cool-aid. We treat shock earlier and more aggressively, but with less fluid. No more waiting for the classic "cool, clammy" patient who looks "shocky". Maybe PASG deserve to remain in the EMS dustbin. Maybe not. What does everyone else think?
    Last edited by JimSpoor; 09-04-2013 at 09:14.
    "There is no second place winner"-- Bill Jordan

  2. #2
    Join Date
    Jul 2000
    Location
    Western Hemisphere
    Posts
    541
    By goodness you have definitely struck a neuro-synapse in THIS dinosaur's gray matter! I used the hell out of MAST pants like no tomorrow in my USCG days on all the intoxicated maritime trauma in our NW Florida AOR. They save lives. These were LONG haul transports from many miles offshore and we had NO USCG aviation support back then. I'm talking 50nm at at max speed of 30kts. Do the math. I used them in GA when I got out of Uncle Sam's Confused Group in the early 90's. Due to rapid transport to trauma centers here in metro-ATL, I used MAST/PASG more often for splinting pelvis & lower extremity fractures. I say we keep 'em on the bus! Let's get on a board or committee, Jim!
    Stay safe!

    FedAgent


 

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