Pneumatic antishock garment

Pneumatic Antishock Garment (PASG)

The Pneumatic Antishock Garment (PASG), also known as Military Anti-Shock Trousers (MAST), is a medical device used to manage circulatory shock, severe blood loss, and pelvic fractures in trauma patients. The PASG is designed to stabilize the patient by increasing peripheral vascular resistance, thereby enhancing blood flow to the core organs such as the heart and brain.

History

The PASG was developed in the 1960s for military use, particularly in the Vietnam War, to treat soldiers with severe injuries and prevent shock during transport to medical facilities. Its use expanded into civilian emergency medical services in the following decades.

Design and Function

The garment consists of inflatable compartments or bladders that encase the lower extremities and abdomen. These compartments can be inflated with air, applying pressure to the lower body and abdomen. This pressure acts to counteract the pooling of blood in the lower extremities, a common occurrence in shock, and to reduce bleeding by applying direct pressure to areas of hemorrhage, particularly useful in pelvic fractures.

Indications

The primary indications for the use of PASG include:

• Control of hemorrhage in pelvic fractures
• Stabilization of hemodynamic status in patients with hypovolemic shock
• Reduction of orthostatic hypotension in patients with spinal cord injuries

Contraindications

Despite its benefits, the PASG has contraindications, including:

• Compartment syndrome
• Pulmonary edema
• Diaphragmatic hernia
• Full-term pregnancy

Procedure

The application of a PASG involves placing the garment around the patient's lower body and inflating the compartments to the recommended pressure. Care must be taken to monitor the patient's vital signs and ensure that the garment is not causing additional harm.

Controversies and Limitations

The use of PASG has been a subject of debate within the medical community. Critics argue that it can complicate the assessment of abdominal injuries, increase the risk of compartment syndrome, and potentially worsen pulmonary edema in patients with heart failure. Due to these concerns, the use of PASG has declined in recent years, with many emergency medical services opting for alternative methods of managing shock and hemorrhage.

Current Status

While the PASG is less commonly used today than in the past, it remains a tool in the arsenal of pre-hospital and trauma care, particularly in situations where other methods of controlling hemorrhage are not available or feasible.