Mast trauma pants

[NYCEMS9115]

Stabbed in the CHEST. MAST contraindicated... There really isn't any need for research or discussion...

The only thing you can do with the MAST for this patient, was to place it where you found the patient. So the Police will have a reference to where the victim was, in their investigation.

Edited May 14, 2011 by NYCEMS9115

[FireMedicChick164]

Hey guys, maybe instead of attacking JLO1965 someone could do some research on the protocols from the early 90's. Also take into consideration that the MAST was originally a military invention to treat those in the field who were gravely wounded so they may have time to get to a field hospital. More info here: http://en.wikipedia.org/wiki/Military_anti-shock_trousers

I'm all for sharing info about what we do and our equipment. Nothing that I said in my first post is anything but facts and I cited my source in my post. If we can't educate the public and/or share info with each other how are we ever going to learn from others mistakes and improve our patient care. Protocols change all the time for a variety of reasons which is why research is being done on a consistent basis.

It also sounds to me from the reply by JLO1965 that the record keeping was sloppy on this case.

Just trying to see things from both perspectives.

Meri

Edited May 14, 2011 by FireMedicChick164

[Richard B the EMT]

EMTs and Paramedics may apply MAST/PASG if not contraindicated, in New York State. Due to insufficient data, I don't know about "First Responders", who have much less training than EMTs, who in turn have less training than the Paramedics, being either trained or allowed to apply them

Until Brian Watkins, a Utah visitor in town for the US Tennis Open, was stabbed in the chest during a mugging in 1990, a penetrating chest trauma was not a contraindication. I presume most of us know the MAST/PASG prevents blood circulation return to the lower extremities, keeping it available for the heart, lungs and brain. Under protocol of that time, he was placed into MAST/PASG, all 3 sections were inflated, his BP came back up, but it assisted in his death from exsanguination via the penetrating chest trauma. The NYC EMS was reamed by the press corps for being reactive, and not proactive, to instituting the current statewide protocol of penetrating chest trauma being a contraindication for use. It was, however, enacted statewide following the NYC EMS' incident.

[hatelilpeepees]

yeah, they also should get someone to the hospital in a timely manner. Not waste time

Again Jlo, trying to help you, but sorry I am not telling you what you wanted to hear. Again, medicine and treatment protocols have changed alot in 20 years, and it is obvious that you want to blame the EMTs for the death. Here are some questions for you :

1. How long did the emts spend on the scene, since you said they wasted time ?

2, What was the cause of death, what was punctured ?

3. How far away was the closest trauma center, if there was one there 18 years ago. If they spent only 1 minute on scene but delivered the patient to the local regular ER, the patient would have probably still died ? The only thing that could have possibly saved this patient was to be on the OR table with a thoracic surgeon standing there ready to do surgery immediately. You didn't say what time of day or night this happened, I assume it was night time on a weekend, which means the chances of a thoracic surgeon being physically present in a hospital is unlikely.

Is it possible that the EMTs could have done a better job, probably, but they didnt stab him. Blaming the EMTs for the death instead of the sorry piece of shit that actually stabbed him, is some really backwards thinking.

[DwayneEMTP]

Bottom line man is that the pants likely had little to no effect at all on the outcome of the patient unless they'd been left in place and wounds had been missed because of it.

The reason that they're not used anymore isn't because they were horrible, but because they had almost no effect. Intuitively it seemed that they should have been a Godsend for trauma, but they just weren't...they turned out to just be in the way.

By modern thinking you will not be going down the right path trying to fry someone for taking them off, as that was necessary for a thorough assessment, and that far back you will likely find little ammunition for putting them on in the first place as they used to be the standard of care.

Most likely? They had no effect and whoever did the killing accomplished what they set out to do. Whether or not it was self defense is irrelevant to the question, and whether or not it was survivable impossible to answer at this date, and certainly at this level of medicine.

There's just no blood in the water on this one brother...

Dwayne

[NYCEMS9115]

Hey guys, maybe instead of attacking JLO1965 someone could do some research on the protocols from the early 90's. Also take into consideration that the MAST was originally a military invention to treat those in the field who were gravely wounded so they may have time to get to a field hospital. More info here: http://en.wikipedia....-shock_trousers

I'm all for sharing info about what we do and our equipment. Nothing that I said in my first post is anything but facts and I cited my source in my post. If we can't educate the public and/or share info with each other how are we ever going to learn from others mistakes and improve our patient care. Protocols change all the time for a variety of reasons which is why research is being done on a consistent basis.

It also sounds to me from the reply by JLO1965 that the record keeping was sloppy on this case.

Just trying to see things from both perspectives.

Meri

I believe most didn't attack JLO; most gave the indications of the MAST. The EMTs were wrong for attaching the MAST on a chest injury (stabbed), regardless of the vitals and other findings. The information provided was to benefit JLO. The perpetrator was wrong for stabbing the victim but I think it was noted as self-defense. Anyway, EMTs would not put on the MAST for this particular patient; it's not indicated, it's contraindicated. I am sure a through investigation and QA/QI will be done with Departmental Discipline, Educational Remidation, and Duty Restriction. That is what I would do; if it was as clear as how JLO explained it.

Okay, when did this event happen? Recently or not recently? Medicine is ever-changing. I was an EMT in 95 and a Paramedic in 98. Pre-Hospital care has changed a lot over my 16 year career and others who have been in the field a lot longer, would say the same.

[paramedicmike]

Okay, when did this event happen? Recently or not recently? Medicine is ever-changing. I was an EMT in 95 and a Paramedic in 98. Pre-Hospital care has changed a lot over my 16 year career and others who have been in the field a lot longer, would say the same.

Did you see the part where the OP mentioned the event in question supposedly took place more than 18 years ago?

[island emt]

back when this event took place Military anti shock trousers were common place in trauma protocols almost everywhere.

Today there are few circumstances that allow them to be used. Most state equipment lists don't even require them to be a part of the required equipment list.

Did the application of MAST cause the death? Hell No ! the person who stuck the knife in his chest caused the death.

END of discussion.

[NYCEMS9115]

Did you see the part where the OP mentioned the event in question supposedly took place more than 18 years ago?

Thank you.

[Richard B the EMT]

FDNY EMS Command took MAST off our ambulances roughly 1998 or 1999, if memory serves.