Abdominal haemorrhage — a preventable cause of death after field stabilization?

Schou, J; Ginz, H. F.; Herion, Hans-Peter; Huck, Dieter; Blum, Reinhard; Fehlmann, Rene; Ummenhofer, Wolfgang

doi:10.1016/s0300-9572(99)00141-0

“…[23] Schou et al reported improved survival rate following the use of MAST in severely hypotensive patients with abdominal trauma where survival will not be possible without the use of MAST. [28] In 1988, a case study of a lower limb crush injury of sixteen year old road traffic accident victim showed that the patient's hemodynamic parameters improved with the use of MAST, after both colloids and group O negative packed failed to improve the parameters, resulting from severe hemorrhagic shock due to a popliteal arterial injury. [30] In the arena of obstetrics and gynecology, MAST made its way into the Journal of Obstetrics, where one woman's life was saved by its use in controlling her torrential hemorrhage in an elective Cesarean delivery.…”

Section: Mast and The Emsmentioning

confidence: 99%

“…Prolonged scene time for MAST application is agruable. [28] Schou J et al disputed on the point of prolonged scene time. They found that 4.7 minutes deployment time at the scene was found to be realistic.…”

Section: Mast and The Emsmentioning

confidence: 99%

“…They found that 4.7 minutes deployment time at the scene was found to be realistic. [28] However, prospective studies done in 1985 had shown that use of MAST at scene do not improve the trauma score in an urban pre-hospital setting. [34] It also been said that in the preventable death evaluation study that 2 deaths were due to pre-hospital delays resulting from the use of MAST at scene.…”

Section: Mast and The Emsmentioning

confidence: 99%

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Military anti-shock garment: Historical relic or a device with unrealized potential?

Lateef

¹

,

Kelvin

²

2008

J Emerg Trauma Shock

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Military anti-shock trousers represents a medical device which has engendered very divergent views, even up to today. From the time the concept was formulated in 1903 by surgeon George W Crile, there have been significant swings in opinion and evidence. The guidelines, where available, are often kept relatively general and cautious. As a spin-off to the mechanism and technology, several alternative devices have been proposed or developed over the years. This include the auto-transfusion torniquet, the non pneumatic anti-shock garment (Life Wrap) and the non inflatable antishock garment, which are discussed in this paper.

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“…In addition to the translocation of blood and the resultant increase in preload, studies in animals show increased peripheral resistance with counterpressure applied to the lower body 9,11–13 . Tamponade of vessels also occurs in the lower body where counterpressure is applied, and this may diminish or arrest further bleeding from the legs, pelvis and abdomen 8,14 . The physiologic bases for these benefits have been well described 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Anti‐shock garment provides resuscitation and haemostasis for obstetric haemorrhage

Hensleigh

¹

2002

BJOG

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Objective To evaluate the feasibility, safety and effectiveness of the non-pneumatic anti-shock garment for resuscitation and haemostasis following obstetric haemorrhage resulting in severe shock. Design During a six-week period, the author served a locum tenens as the obstetrician consultant for the Memorial Christian Hospital, Sialkot, Pakistan. All women who suffered from severe obstetric haemorrhage were managed with the anti-shock garment as the first intervention. The data for this report were collected from hospital chart review. Setting Sialkot is a city of about three million and Memorial Christian Hospital is one of two major obstetric hospitals. There is no blood bank at Memorial Christian Hospital or elsewhere in Sialkot. The Memorial Christian Hospital laboratory is able to draw donor blood, type and cross match blood, and process it for transfusion 24 hours per day. Population During the six weeks of this study, in June and July 2001, there were 764 deliveries and 34 other admissions within a week following deliveries outside the hospital. Seven women with obstetric haemorrhage who developed severe shock were managed with the anti-shock garment. One woman, who was later found to have mitral stenosis, developed dyspnea upon placement of the anti-shock garment and therefore it was removed within 5 minutes. This report concerns the six women who were able to tolerate the anti-shock garment without untoward symptoms. Methods As soon as severe shock was recognised in the hospital, the anti-shock garment was placed.Crystalloid solutions were given intravenously over the first hour at a rate of 1500 mL per estimated litre of blood loss, then at a maintenance rate of 150 mL/hour. Vital signs every 15 to 30 minutes, hourly urine output and intermittent oxygen saturation were used to monitor patients during the use of the anti-shock garment. When sufficient blood transfusion had been given to restore the haemoglobin to >7 g/dL, the anti-shock garment was removed in segments at 15-minute intervals with documentation of vital signs before removal of each subsequent portion. Main outcome measures Restoration of mean arterial pressure of 70 mmHg and clearing of sensorium were considered as signs of effective resuscitation. Haemorrhage was considered controlled if the blood loss was less than 25 mL/hour. Morbidity included any complications noted in the medical chart. Results Restoration of blood pressure and improvement of mental status occurred within 5 minutes in two patients who were pulseless and three who were unconscious or confused. All patients had improvement of mean arterial pressure to greater than 70 mmHg within 5 minutes. Duration of anti-shock garment use ranged from 12 to 36 hours and none of the six women had significant further bleeding while the antishock garment was in place. Patients were comfortable during use of the anti-shock garment and no adverse effects were noted apart from a transient decrease in urine output. Conclusions The anti-shock garment rapidly restored vital signs in women wi...

show abstract

“…In addition to the translocation of blood and the resultant increase in preload, studies in animals show increased peripheral resistance with counterpressure applied to the lower body 9,11 -13 . Tamponade of vessels also occurs in the lower body where counterpressure is applied, and this may diminish or arrest further bleeding from the legs, pelvis and abdomen 8,14 . The physiologic bases for these benefits have been well described 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Anti-shock garment provides resuscitation and haemostasis for obstetric haemorrhage

Hensleigh

¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To evaluate the feasibility, safety and effectiveness of the non-pneumatic anti-shock garment for resuscitation and haemostasis following obstetric haemorrhage resulting in severe shock. Design During a six-week period, the author served a locum tenens as the obstetrician consultant for the Memorial Christian Hospital, Sialkot, Pakistan. All women who suffered from severe obstetric haemorrhage were managed with the anti-shock garment as the first intervention. The data for this report were collected from hospital chart review. Setting Sialkot is a city of about three million and Memorial Christian Hospital is one of two major obstetric hospitals. There is no blood bank at Memorial Christian Hospital or elsewhere in Sialkot. The Memorial Christian Hospital laboratory is able to draw donor blood, type and cross match blood, and process it for transfusion 24 hours per day. Population During the six weeks of this study, in June and July 2001, there were 764 deliveries and 34 other admissions within a week following deliveries outside the hospital. Seven women with obstetric haemorrhage who developed severe shock were managed with the anti-shock garment. One woman, who was later found to have mitral stenosis, developed dyspnea upon placement of the anti-shock garment and therefore it was removed within 5 minutes. This report concerns the six women who were able to tolerate the anti-shock garment without untoward symptoms. Methods As soon as severe shock was recognised in the hospital, the anti-shock garment was placed.Crystalloid solutions were given intravenously over the first hour at a rate of 1500 mL per estimated litre of blood loss, then at a maintenance rate of 150 mL/hour. Vital signs every 15 to 30 minutes, hourly urine output and intermittent oxygen saturation were used to monitor patients during the use of the anti-shock garment. When sufficient blood transfusion had been given to restore the haemoglobin to >7 g/dL, the anti-shock garment was removed in segments at 15-minute intervals with documentation of vital signs before removal of each subsequent portion. Main outcome measures Restoration of mean arterial pressure of 70 mmHg and clearing of sensorium were considered as signs of effective resuscitation. Haemorrhage was considered controlled if the blood loss was less than 25 mL/hour. Morbidity included any complications noted in the medical chart. Results Restoration of blood pressure and improvement of mental status occurred within 5 minutes in two patients who were pulseless and three who were unconscious or confused. All patients had improvement of mean arterial pressure to greater than 70 mmHg within 5 minutes. Duration of anti-shock garment use ranged from 12 to 36 hours and none of the six women had significant further bleeding while the antishock garment was in place. Patients were comfortable during use of the anti-shock garment and no adverse effects were noted apart from a transient decrease in urine output. Conclusions The anti-shock garment rapidly restored vital signs in women wi...

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Abdominal haemorrhage — a preventable cause of death after field stabilization?

Cited by 8 publications

References 22 publications

Military anti-shock garment: Historical relic or a device with unrealized potential?

Military anti-shock garment: Historical relic or a device with unrealized potential?

Anti‐shock garment provides resuscitation and haemostasis for obstetric haemorrhage

Anti-shock garment provides resuscitation and haemostasis for obstetric haemorrhage

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