Shock pants

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The shock pants are used in preclinical emergency medicine with the aim of immobilization, splinting, hemostasis and autotransfusion , in order to be able to better control the situation after severe injuries with volume deficiency shock .

In the application, the shock pants are pulled over the legs and pelvis and then specifically inflated with air, which both compresses the venous system and thus improves the blood return to the heart, and at the same time stabilizes the legs and pelvic ring. Their use has both advantages and disadvantages and is considered obsolete in Germany.

Synonyms

Synonymously in particular in the English language, the terms Military anti-shock trousers (MAST) , Trauma Air Pants , Medical anti-shock trousers and pneumatic anti-shock garments (PASG) and in German-speaking anti-shock trousers used.

development

Military Anti-Shock Trousers were during the Vietnam War by Lt. Col. Burton Kaplan . The idea of ​​inflatable compression pants goes back to George W. Crile , who used Pneumatic Rubber Suits as early as 1903 for the prophylaxis of air embolisms in interventions in the head and neck area. During the Second World War , inflatable trousers were used by fighter pilots. These should prevent blood from sinking into the lower extremities of the pilot. This enabled fighter pilots to fly daring maneuvers with a fighter aircraft, where there were large acceleration values, without the pilot losing consciousness. During the Vietnam War, the principle of compression of the lower extremities using inflatable pelvic and leg splints was further developed. Anti-shock pants were used especially for mine wounds. Military anti-shock trousers are also used in regular rescue services , especially in the USA . The Bundeswehr also has such equipment on its helicopters and ambulance vehicles.

Function and use

Anti-shock pants compress the lower extremities so that more blood is available to the central circulation through autotransfusion . Compression results in a shift in the amount of blood. The pressure in the pressure hulls can be adjusted from 40 to 100 mm Hg, whereby they should be inflated until the patient's hemodynamic condition improves. The pressure is controlled by a manometer . The pressure of the rails is built up by a simple foot-operated pump.

The use of anti-shock pants is not without controversy. In addition to the high costs, critics bring other problems into the discussion. Often, hospital emergency room personnel are not trained in handling such pants. It can happen that the pants are cut open with scissors, with fatal consequences, as the blood pressure drops massively due to the sudden decompression. For this reason, a warning was placed on MAST to open the manometer on the trousers slowly and not to cut the trousers in any way. The effectiveness is also controversial. A Cochrane review found no survival benefit.

Anti-shock pants that work without air chambers have been on the market for some years. They are called Non-Pneumatic Anti-Shock Trousers (NP-AST), L-Mast or "Non-pneumatic anti-shock garments" (NASG). NP-AST / NASG are cheaper to buy and easier to use and are intended to serve the same purpose.

literature

  • F. Lateef, T. Kelvin: Military anti-shock garment: Historical relic or a device with unrealized potential? In: J Emerg Trauma Shock. 1 (2), Jul 2008, pp. 63-69. PMID 19561982
  • FJ Seibert, B. Schatz, B. Petutschnig, G. Prause: Non-Pneumatic Anti Shock Trousers (NP-AST). In: European Surgery. Volume 34, Supplement 2/2002, pp. 37-40.
  • U.S. Patent Medical Pneumatic Trousers For Emergency Autotransfusion No. 3933150 Jan. 20, 1976 Burton Kaplan

Individual evidence

  1. ↑ C. Madler among others: The NAW book: Acute medicine of the first 24 hours. Urban & FischerVerlag, 2005, ISBN 3-437-22510-3 , p. 348, (books.google.de)
  2. ↑ B. Lutomsky et al.: Guide to the rescue service. Elsevier, Urban & FischerVerlag, 2006, ISBN 3-437-47151-1 , p. 345. (books.google.de)
  3. ↑ R. Rossi among others: The emergency service examination: questions, topics, tasks. Springer, 2007, ISBN 978-3-540-46656-7 , p. 495, (books.google.de)
  4. ↑ a b G. H. Engelhardt among others: Accident medicine. Verlag Walter de Gruyter, 1998, ISBN 3-11-015096-4 , p. 245, (books.google.de)
  5. ↑ K. Ellinger: Course book emergency medicine: Oriented on the nationwide curriculum to obtain the additional designation emergency medicine. Deutscher Ärzteverlag, 2006, ISBN 3-7691-0519-2 , p. 526. (books.google.de)
  6. ^ ADAC: Christoph 30 - The equipment. ( www.christoph30.com ( Memento of February 27, 2014 in the Internet Archive )) accessed on July 29, 2009.
  7. ↑ a b K. Dickinson et al .: Medical anti-shock trousers (pneumatic anti-shock garments) for circulatory support in patients with trauma. In: Cochrane Database Syst Rev. (2), 2000, p. CD001856. Review. PMID 10796828
  8. ^ T. Ziegenfuß: Emergency Medicine. Springer, 2007, ISBN 978-3-540-48633-6 , p. 51. (books.google.de)