Mast Pants

[medic82942003]

I was watching a old Squad 51 (Emergency), and they put mast pants on a patient for

unstable BP with hip trauma. In Michigan we dont carry them any more. anyone still carry them/ have it in your protocols. Just wondering?

[Chief1C]

Did a truck back into him in a loading dock? What season/episode is it?

They're optional for us, in fact, they're not even on the M.B.E.L. Minimum Basic Equipment List. But they're in the protocols. (Penna) I was in the last class to be taught their proper use, locally, and that was ten years ago. Now, for pelvic fractures, we'd use the SAM Slings.

I can't exactly recall the number of times I've used them, but it's been quite a number of times. Pelvic fractures, multiple fractures of the legs and shock. I've seen it used many times, and used it myself for it's intended purpose. Everything we do has pros, cons, positive outcomes and eventual death. It's just another tool in the bag of tricks. Had a boy fall through a hay loft door in a barn the summer after I became an EMT. We carry an unusual amount of traction splints. Don't ask. He had both femurs, and a lower left leg fracture. The other EMT was actually going to put a Pedi Hare on the right leg, and a Thomas on the left. Never liked me after that day, I said it's 99, not 69.. We used the Pedi MAST. That was the last time I used the child set. The patient still had pedal pulses, and had a significantly reduced amount of pain. Pain isn't just a symptom that we can brush off, even some relief, is beneficial to the victim.

We joke around as a mood breaker, a tell tale sign someone's going to die, is when we get out the shock suit. Rural, backwoods, EMS, 'God' hates us. Time just isn't in our court. Just like other things in the compartments. It's not used that often, lots of literature to support it, and denounce it. Hell, it may have a come back someday. I doubt it; but either it works or it doesn't. But I'm implying that it's something that you may not consider using, so when you do, chances are the victim's in a pretty bad way.

[chbare]

I still see ground based EMS providers apply MAST pants primarily to stabilize suspected orthopedic trauma. In recent years, MAST pants have fallen out of favor. A review of the literature is all over the place. Benefits and pitfalls of MAST pants use are also all over the place. However, with the concepts of "permissive hypotension" and "damage control" resuscitation & surgery coming out of the middle East, I would have to hypothesize that the concepts in support of applying MAST pants go against current evidence based medicine.

Take care,

chbare.

[Bamx]

Rhode Island uses them and it seems to be a huge joke because a big contraindication of them is < 5 minutes from a hospital. There are very few places in RI that are more then 10 minutes from a hospital. Had to learn them in my basic class though. One of the instructors told us that there was some documentation from Texas saying how using them causes people's hospital stays to be longer.

-Bamx

[chbare]

Rhode Island uses them and it seems to be a huge joke because a big contraindication of them is < 5 minutes from a hospital. There are very few places in RI that are more then 10 minutes from a hospital. Had to learn them in my basic class though. One of the instructors told us that there was some documentation from Texas saying how using them causes people's hospital stays to be longer.

-Bamx

Some documentation is not much to go on when making decisions about your clinical practice.. Here is a link to a recent article that summarizes allot of the data and literature about MAST pants.

http://www.pubmedcentral.nih.gov/articlere...i?artid=2700619

Take care,

chbare.

Edited July 22, 2009 by chbare

[Chief1C]

Isn't it the "Medical.. Anti-Shock Trouser", rather than Military..

[chbare]

MAST pants were initially known as "military" anti-shock trousers. The MAST concept dates back as far as the early 1900's; however, MAST pants were introduced and used as we know them during the Vietnam conflict. Hence the term "military."

Take care,

chbare.

[Chief1C]

I skimmed that link that chb posted, glad to see it listed recommended use in ruptured AAA. I've noted in past discussions that we used it in suspected ruptured triple A's, based on past history, symptoms and decompensated shock. One was an aortic injury, but we applied it due to massive trauma and hypotension. Bought him enough time to talk to a family member before we took him to the chopper. So, even though he died, it did serve a purpose that probably helped with some closure. Had a few instances where it delayed the inevitable, but ultimately, death won.

[CBEMT]

One of the instructors told us that there was some documentation from Texas saying how using them causes people's hospital stays to be longer.

-Bamx

Their stays in the ground are even longer.

[ffemt2311]

I was watching a old Squad 51 (Emergency), and they put mast pants on a patient for

unstable BP with hip trauma. In Michigan we dont carry them any more. anyone still carry them/ have it in your protocols. Just wondering?

I know in Delaware they're not used here anymore.