EMS Equipment - Shock Pants

EMS providers should be aware of the following key points regarding Military Anti-Shock Trousers (MAST) and Pneumatic Anti-Shock Garment (PASG):

1. Purpose: MAST and PASG are devices used to manage hemorrhagic shock and hypovolemia. They help stabilize patients by applying external pressure to the lower extremities, which helps redirect blood to vital organs and increase blood pressure.

2. Mechanism of Action: MAST and PASG apply circumferential pressure to the legs and lower abdomen. This pressure compresses the blood vessels, reducing blood pooling in the lower extremities and promoting blood flow back to the heart and brain.

3. Application: MAST consists of a pair of inflatable trousers, while PASG is a single-piece garment that wraps around the patient's lower body. They are typically applied to patients with suspected or confirmed hemorrhagic shock or hypovolemia. The garments are inflated using a manual or automatic pump until a specific pressure is achieved.

4. Considerations: EMS providers should be cautious when applying MAST or PASG, as these devices may have contraindications and potential complications. It is essential to follow proper application techniques and adjust the pressure according to the patient's condition and vital signs. Regular reassessment of the patient is crucial to ensure adequate perfusion.

5. Limitations: MAST and PASG are considered adjuncts to other resuscitative measures and should not replace definitive interventions or delay transportation to a medical facility. They are not suitable for patients with certain injuries or conditions, such as fractures, burns, or abdominal trauma.

6. Training and Familiarity: EMS providers should receive appropriate training on the correct application, monitoring, and potential complications associated with MAST and PASG. Familiarity with local protocols and guidelines is crucial for safe and effective use.

Remember, the use of MAST or PASG should be based on specific protocols, medical direction, and individual patient assessment. Always consult local guidelines and medical control when considering the use of these devices.

Additional Reading:

https://www.ncbi.nlm.nih.gov/books/NBK534783/

https://www.hmpgloballearningnetwork.com/site/emsworld/article/10325078/ems-myth-1-medical-anti-shock-trousers-mast-autotransfuse-significant-amount-blood-and-save-lives

EMS Pharmacology - Aspirin (Acetylsalicylic Acid)

EMS Providers should have knowledge of aspirin administration including, amongst other things, its mechanism of action, the effect, and contraindications 

Here are key points to know:

Indications: Aspirin is commonly used in emergency situations to treat suspected heart attacks (myocardial infarctions). It helps prevent blood clot formation and reduces the risk of further cardiac damage.

Mechanism of Action (MOA): Acetylsalicylic acid is an antiplatelet agent. It works by inhibiting the activity of an enzyme called cyclooxygenase (COX). COX is involved in the production of prostaglandins, which play a role in platelet aggregation (clumping) and vasoconstriction.

Effect: By inhibiting COX, aspirin reduces the formation of thromboxane A2, a substance that promotes platelet aggregation and vasoconstriction. As a result, aspirin makes platelets less sticky and less likely to form blood clots. It primarily affects platelet function and is often used to prevent arterial thrombosis, such as in cases of myocardial infarction (heart attack) or stroke.

Dosage: The recommended dosage of acetylsalicylic acid for suspected heart attacks is typically 4 x 81 mg ‘baby aspirin’. EMTs should follow local protocols and medical direction regarding the specific dosage and formulation used.

Route: Aspirin is usually administered orally, which means EMTs may give the patient chewable or crushed aspirin tablets to be swallowed. It is important to ensure the patient can safely swallow the medication and has no contraindications.

Contraindications: EMTs should be aware of contraindications for aspirin administration, such as a known allergy to aspirin, active bleeding, or a history of gastrointestinal bleeding or ulcers. 

If the patient has any contraindications, aspirin should not be administered, and medical direction should be sought.

Documentation: EMS Providers should document the administration of aspirin, including the dosage, time, and the patient's response. Accurate documentation helps ensure continuity of care and provides important information to healthcare providers, including whether the patient has already taken aspirin.

Communication: EMTs should inform receiving healthcare providers about the administration of aspirin, including the dosage and timing. This helps ensure appropriate follow-up care and treatment continuation.

Remember, EMS Providers should always adhere to their local protocols and receive proper training on aspirin administration. They should work under medical direction and consult with a physician or follow local guidelines when administering aspirin to patients.