MAST Pants....

[paratek]

BLS in our system don't carry them, but ALS do. Usually for unstable pelvic fractures or in rare instances to aid in IV initiation for extremely poor venous access.

paratek

[akeith106]

We have them... But I have yet to see them used.

I usually end up having to clean the dust off of them... That's the only time they are removed from the cupboard!!!

[Alcomedicism]

I would think they wouldnt be used unless there would be a long transport time, because if there is a short transport or if Life Flight were coming, it would just take too long to put them on the pt. Alot of times if a pt is that serious around here, they just load n' go and drive like hell to the ER. The medics here arent going to waste precious time putting the MAST on if they cant get the pt to a ER pronto.

My two cents.

-Dix

[tunnelrat83]

I think if you know that you are going to need them get them laid out on the board... and then place them on the pt... otherwise they don't get used...

[emtmoira]

I remember being taught how to use them and I remember being told the specific cases in which to use them but I'm pretty sure no one around here has used them in a long long time. I think they would qualify as the least used piece of equipment on the truck.

[fdnyemt5330]

MAST pants are no longer a part of the protocol in NYC. Besides, the only time I used them was in refresher.

[Richard B the EMT]

I just remembered something: For those agencies still using MAST, if doing a Medivac, the pressure in the MAST will be changing due to good old barometric pressure, with the helo's changing altitude!

[THE_DITCH_DOCTOR]

I just remembered something: For those agencies still using MAST, if doing a Medivac, the pressure in the MAST will be changing due to good old barometric pressure, with the helo's changing altitude!

Excellent point. The same theoretical change in pressure occurs in ET tube cuffs (that's why my personal policy is to inflate the cuff with saline if I think the patient is likely to be flown (between the recieving hospital and the trauma center) or if they are going into a hyperbaric chamber).

Most people assume that this only occurs if you are flying high enough that require cabin pressurization (wrong!). but the pressure gradient is greatest within the first 305 meters (about 1000 ft) of the atmosphere because this is where the air is densest.

[Ridryder 911]

Very true USAF, as all cuff or pressure devices.

I would like may a comment on PASG (MAST) etc. Yes these devices are rarely used except for pelvic stabilization etc. I hope we can learn by what happened to this device & studies. They were very popular in the late 1970's- to late 80's, yes I did see them work at about 50% of the time.

No they do NOT correct shock, & yes they did raise blood pressure (which is NOT always a good thing). The Houston PASG study was published & voom!, EMS knee jerked over this & immediately started removing the devices.

If you read the FULL study, what it said was "there was NO change in outcome "(with or without). Again, if you look at the WHOLE study, & compare the trauma patients based on the TRISS (trauma index severity scale) that these patients had, has a low outcome anyway. I believe that these injuries were so severe in this study, that even if you had a trauma surgeon beside them, the outcome still would be low.

The main emphasis for the study, was "we don't really know the mechanism of how they work, side effects, etc." I personally know 2- of the physicians that were authors of this landmark study. They make the point of emphasizing increasing pressure = increases injury. (Duh..) more pressure- bigger hole. The authors also recommend letting the body to maintain homeostasis in a shock state. I argue the point that we need to maintain cerebral perfusion pressure as well as coronary artery perfusion level. (If we do not perfuse the brain, what difference does resuscitation matter ?) Theses Physicians have also authored several other articles on no fluid resuscitation etc..

Some of my concerns in earlier debates was that the study application of the PASG. (Pop-off valves released..wow. try that on a mannequin) & the amount of time & duration the PASG was left on the patient.

Yes, I believe that this device has several limitations & possibly may due harm, if not used properly. My main concern was before a comparison study was performed we acted hastily & changed protocols & removed PASG before all the facts were in. Any medical device(s) should be evaluated & studied BEFORE used for patient care. I read on another forum Paramedic using the wave form for blood pressure eval.. again a scientific study should be applied before doing such.

Be safe,

Ridryder 911

[tunnelrat83]

very good poiint.. forgot about he pressure change.. even though was told about how if you are going to fly them fill cuffs w/ saline... but i forgot about that in the mast trousers

thnx for reminding us about that