Overview of MAST Pants
Medical anti-shock trousers (also known as MAST, military anti-shock trousers or pneumatic anti-shock garments) are medical devices that are inflatable and cover parts of a patient’s body including the stomach, pelvis, and legs. These devices have different compartments, and each can be inflated at different pressures. The basic idea behind these devices is to apply pressure to the lower parts of the body in order to move blood from the stomach, pelvis, and legs to the upper body in case of emergencies. They were also believed to help slow down bleeding in the stomach and lower body, and provide support to injured bones in the legs.
These trousers were first used in 1903 by a surgeon named G.W. Crile during brain surgery. Later, during the Vietnam War, medics used these trousers to stabilize injured soldiers before flying them to a hospital. After the war ended in 1975, soldiers who were doctors and medics suggested using these trousers in emergency situations outside of war, and in 1977, they were listed as must-have items in every ambulance. They were commonly used on patients with low blood pressure due to injures in the 70s and 80s across America.
However, the use of these trousers has faced a lot of backlash. Initial studies suggested that the trousers effectively moved up to 20% of a patient’s total blood volume to the upper body. However, later studies disputed these findings and suggested that less than 5% of a patient’s overall blood volume was moved to higher parts of the body by these trousers. Furthermore, some studies showed harmful side effects of using these trousers, such as increased pressure in enclosed muscle space (compartment syndrome) and insufficient blood supply to the legs (ischemia).
Further research also suggested that these trousers did not improve survival rates or reduce the amount of time spent in the hospital. Despite the mixed results, their use was supported in specific cases by the National Association of Emergency Medical Services Physicians in 1997. However, in 2002, a review suggested that using these trousers in fact increases the length of a hospital stay in the intensive care unit. Given these findings, the use of these trousers began to decrease. By 1995, not many hospitals or emergency services in the UK were using them.
Anatomy and Physiology of MAST Pants
The MAST device, which is a type of medical equipment, is placed about one inch below the ribcage. This device covers the belly, hip region, and lower part of the legs.
Why do People Need MAST Pants
At present, there are no universally accepted guidelines on when to use certain medical devices. Important medical organizations such as the American College of Surgeons’ Advanced Trauma Life Support and the American College of Emergency Physicians do not recommend their use at this time.
In the past, the reasons to use these devices typically included situations of:
1. Low blood pressure linked with suspected fractures of the pelvis or thigh bone.
2. A burst aorta in the abdomen (the body’s main artery).
3. Stabilizing fractures of the pelvis and thigh bone.
When a Person Should Avoid MAST Pants
There are certain situations where a person should not undergo specific procedures. These include:
– If the person has congestive heart failure (CHF), which is a condition where the heart doesn’t pump blood as well as it should.
– If they’ve had a myocardial infarction, commonly referred to as a heart attack, where the flow of blood to the heart is blocked.
– If they’ve had a stroke, which happens when the blood supply to the brain is interrupted or reduced.
– If the person is pregnant, as certain procedures could harm the developing baby.
– If they’ve had a thoracic hemorrhage, which is heavy bleeding in the chest area.
– If they have a diaphragmatic injury, which means damage to the muscle that helps you breathe (the diaphragm).
– If they’ve had severe head injuries, which could cause brain complications.
– If they have an abdominal injury with evisceration, which means the organs in the abdomen have been displaced or are protruding out.
– If they have uncontrolled bleeding above the level where a particular garment or device is placed.
– If they have an impaled object in the abdomen or lower extremity, which means something sharp has pierced and is stuck inside.
Equipment used for MAST Pants
This is a list of medical tools that might be used in your care:
* Medical anti-shock trousers: These are specialized trousers used to increase blood flow to vital organs like the heart and brain, particularly in shock or low blood pressure situations.
* Pump or inflation device: This tool is used to inflate the anti-shock trousers, ensuring they apply the right amount of pressure to your body.
* Sphygmomanometer: This is what doctors use to check your blood pressure. It usually involves a cuff placed around your arm that inflates and measures how hard your blood is pushing against your arteries.
* Stethoscope: A common medical tool you’ve likely seen before, a stethoscope is used by doctors to listen to your heart and lungs inside your body.
Who is needed to perform MAST Pants?
The MAST device, used in emergency situations, should only be used by trained healthcare experts. These include doctors, nurses, and emergency medical staff. It only takes one trained person to use the MAST device properly.
Preparing for MAST Pants
Before moving the patient, make sure to place a medical anti-shock trousers (MAST) device on their stretcher or long backboard. Then, transfer the patient onto it. Once they’re safely on the stretcher or backboard, give them a physical check-up. This is to make sure it’s safe to put on the MAST device and that there are no injuries that would be hidden when it’s inflated. If everything checks out and there are no issues, then you can put on and inflate the MAST device.
How is MAST Pants performed
When using MAST (Medical Anti-Shock Trousers), an inflatable garment that is often used during emergencies to improve blood flow, the steps are as follows:
1. First, you’ll need to examine the patient’s injuries and take their vital signs, like heart rate, blood pressure, and temperature, to understand whether MAST pants are necessary.
2. Then, the MAST pants should be unfolded and spread out on a transfer board or a stretcher before the patient is placed on it.
3. A closer examination of the patient’s injuries is done next. This is to identify any wounds covered by the MAST pants. Any wounds identified must be treated and all clothes and foreign objects need to be removed, as MAST pants could press these into the patient’s skin.
4. Making sure the patient’s spine is not moved, they must be positioned on the MAST pants. The top of the pants should be about an inch below the bottom edge of the patient’s ribs.
5. The leg sections of the MAST pants need to be fastened securely. Make sure there are no folds in the material.
6. Similar to the legs, the abdominal (belly) section needs to be tightened, unless it is not advisable due to a specific medical condition. No creases should be left and the positioning of the pants’ top edge should not have changed.
7. Connect the air pump to the pants and ensure all the valves are tightly closed.
8. You should then inflate the leg compartments of the MAST pants.
Following these steps, the patient’s status and vital signs should be checked again. If the patient’s blood pressure measurement is in the range of 100 to 110 mm Hg (which is considered within normal levels), keep the valves shut and regularly track the patient’s blood pressure levels. Aim not to raise the blood pressure above 110 mm Hg. If the levels are not within this range, inflate the belly compartment in the MAST pants. Then you should continue to monitor the patient’s blood pressure, adjusting the amount of air in the pants as necessary to keep blood pressure between 100 to 110 mm Hg. The MAST pants should only be removed when a doctor confirms that the patient’s condition has sufficiently improved and it’s safe to do so.
Possible Complications of MAST Pants
MAST pants, which are used in some medical situations, can sometimes lead to various health complications including:
Lower extremity ischemia: This is a condition where blood flow to your legs is reduced. This can cause pain and, in severe cases, might damage your leg tissues.
Compartment syndrome: This is a painful condition that happens when pressure builds up within your muscles to dangerous levels. This pressure can decrease blood flow, preventing nourishment and oxygen from reaching your muscle and nerve cells.
Respiratory Failure: This is a condition where your lungs fail to properly exchange oxygen and carbon dioxide, making it hard for you to breathe.
Increased intracranial pressure: This means that there’s too much pressure inside your skull, often due to swelling in the brain. It can result in brain damage if not treated promptly.
Acute kidney injury: This happens when your kidneys suddenly stop working correctly, which can result in a buildup of waste products in your body.
Metabolic acidosis: This condition is caused by a buildup of acid in your body. When your body fluids contain too much acid, it means that your body is either producing too much acid, or it’s not getting rid of enough. It can become dangerous if symptoms are severe or last for a long time.
These are potential risks, but it’s important to remember that doctors use MAST pants because they can be very helpful in certain situations. They always weigh the potential benefits against any possible risks.
What Else Should I Know About MAST Pants?
MAST devices, or medical anti-shock trousers, were once commonly used in emergency medical services. These devices were believed to help in certain medical emergencies. However, in the United States, most hospitals and emergency services no longer use them.
The main reasons for this change are that there isn’t enough scientific evidence to confirm they work effectively, the costs are high compared to other forms of treatment, and no clear guidelines exist when to use them. As a result, in many developed countries, using MAST devices is often not part of the usual care.
So, right now, the current evidence doesn’t support the continued use of MAST devices. It’s important to know that treatment methods and devices often change over time, as doctors get more information from research and practice.
