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Medical Anti-Shock Trousers: Pneumatic Anti-Shock Garment: Does it Work?

Published online by Cambridge University Press:  28 June 2012

Norman E. McSwain Jr.
Affiliation:
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA

Extract

The use of the Pneumatic Anti-Shock Garment (PASG) has created much controversy in prehospital care. It is interesting that such an inexpensive device and technique has created so much controversy regarding effectiveness when expensive devices and techniques, such as coronary artery bypass, carotid endarteroectomy, and laser angioplasty have been questioned as to effectiveness, but have not created as much controversy.

Where do we stand on the PASG today? One well-done, randomized, prospective study has been reported as several different papers. In reality, these reports originate from only one study (1-5). This is compared to more than 200 other studies, many of which have been randomized, prospective studies in animals using the same quality as the randomized, prospective study done on humans. Such studies have the advantage of having better isolation of the specific condition being studied. It does not seem appropriate to base the clinical use or non-use on just one study. All studies should be reviewed and placed in context when attempting to identify the role the PASG has in patient care.

Type
Controversy
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1989

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References

1. Mattox, KL, Pepe, PE, Bickell, WH, et al. : The MAST controversy-analysis of 911 hypotensive patients prospectively randomized. Presented at the American Association for the Surgery of Trauma, Forty Eighth Annual Meeting, Newport Beach, CA, October 6–8, 1988; pp. 44.Google Scholar
2. Mattox, KL, Bickell, WH, Pepe, PE, et al. : Prospective randomized evaluation of antishock MAST in post-hypotentension. J Trauma 1986; 26:779786.CrossRefGoogle Scholar
3. Pepe, PE, Bass, RR, Mattox, KL: Clinical trials of the pneumatic antishock garment in the urban setting. Ann Emerg Med 1986; 15:14071410.CrossRefGoogle Scholar
4. Bickell, WH, Pepe, PE, Wyatt, CH, et al. : Effect of antishock trousers on the trauma score: A prospective analysis in the urban setting. Ann Emerg Med 1985; 14:218222.CrossRefGoogle Scholar
5. Bickell, WH, Pepe, PE, Bailey, ML, et al. : Randomized trial of pneumatic antishock garments in the prehospital management of penetrating abdominal injuries. Ann Emerg Med 1987; 16:653658.CrossRefGoogle ScholarPubMed
6. Bellamy, RF, DeGuzman, LR, Penderson DC: Immediate hemodynamic consequences of MAST inflation in normo and hypovolemic anesthetized swine. J Trauma 1984; 24:889895.CrossRefGoogle ScholarPubMed
7. Shenasky, JH II: The renal hemodynamic and functional effects of external counterpressure. Surg Gynecol Obstel 1972; 134:253258.Google ScholarPubMed
8. Wangensteen, SL, Ludewig, RM, Eddy, DM: The effect of external counterpressure on the intact circulation. Surg Gynecolo Obstet 1968; 125:253258.Google Scholar
9. McSwain, NE Jr: Pneumatic anti-shock garment: State of the art 1988. Ann Emerg Med 1988; 17:506525.CrossRefGoogle ScholarPubMed
10. Wangensteen, SL, Ludewig, RM, Cox, JM: The effect of external counterpressure on arterial bleeding. Surgery 1968; 64:922927.Google ScholarPubMed
11. Flint, LM Jr, Brown, A, Richardson, JD, et al. : Definitive control of bleeding from severe pelvic fractures. Ann Surg 1979; 189:709716.CrossRefGoogle ScholarPubMed
12. Aberg, T, Steen, S, Othman, K, et al. : The effect of pneumatic anti-shock garment in the treatment of combined hepatic and caval injuries in rats. J Trauma 1986; 26:727732.Google Scholar
13. Aberg, T, Steen, S, Vagianos, C, et al. : The effects of pneumatic antishock garments in the treatment of critical abdominal injuries in rats. J Trauma 1988; 28(6):772778.CrossRefGoogle ScholarPubMed
14. Traverso, LW, Lee, WP, DeGuzman, LR: Military anti-shock trousers prolong survival after otherwise fatal hemorrhage in pigs. J Trauma 1985; 25:10541058.Google ScholarPubMed
15. Mackerzie, RC, Christensen, JM, Lewis, FR: The prehospital use of external counterpressure: Does MAST make a difference? J Trauma 1984; 24:882888.CrossRefGoogle Scholar
16. Gustafson, RA, McDowell, DE, Savrin, RA: The use of the MAST suit in ruptured abdominal aortic aneurysms. Am Surg 1983; 49:454459.Google ScholarPubMed