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PASG / MAST in the field
We all have been trained on how to use this equipment, but has anyone used it in the field? During training I was told, "You have to know this to be licensed, but don't count on ever seeing it again." And I haven't ever seen them again. Maybe I just never had the opportunity. What's everyone else's experience with these?
Replies to This Discussion
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Permalink Reply by Ben Waller on
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A good bilateral traction splint like the Super Sager does a better job of stabilizing femur fractures than does any pneumatic splint. The key difference is that the traction splint helps reduce the fractured bone end overlap while the MAST/PASG do not.
Bilateral traction splints also don't require nearly as much patient movement, which will reduce pain and potentially eliminate some potential for secondary injury that movement during MAST/PASG application has.
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Permalink Reply by Medicine Man on
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Good point Ben, if the injury is bilateral femur fx, or single femur there are many other devices that are better suited for that. However in the case of multiple lower leg fx's traction splints would not be appropriate. This is the case for which I have used them. Like I stated in my previous post. Femur and open tib/fib, where traction splints would not work.
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Dont have many auto accidents in your area Chris? Or do you not have protocols for using the KED in your area. This is another of those tools that people are scared of because it is not used much. It is a viscious cirle in some ways. Its not used cause I am not familiar with it and I am not familiar with it because I don't use it.
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I agree that traction splints aren't appropriate if you have tib/fib fractures to go with the femur fractures. However, if you have that many long bone fractures, you have the potential for exanguination, which makes this a Priority 1 trauma patient.
Priority 1 trauma patients should not have transport delayed in order to provide any intervention that is not absolutely lifesaving in the field. Those interventions include airway, breathing/oxygen, and circulation support, decompressing tension pneumothorax, sealing sucking chest wounds, and preventing further injury that could be caused by movement. That means immobilize the patient on a long spineboard. Full spinal immobilization provides adequate splinting for multiple leg fractures. Every second we spend applying MAST/PASG is a wasted second.
Also, if the patient's legs are shattered top to bottom, why add the extra movement necessary to apply MAST/PASG? Bone ends are sharp - picture razor blades. Any little movement caused by MAST/PASG application is the equivalent of slicing the inside of the patient's legs with razor blades.
MAST/PASG aren't an option in my system any more - we recently removed them from service per our Medical Director's orders.
Ben
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Permalink Reply by danny on
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They took the mast off all the emgerency vehicles in Ga. It seems the problem with the use of the mast wasn't in the field but rather in the hospital setting.
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Permalink Reply by Firefighter Nation WebChief on
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This is probably a good question to also ask on our sister social network at JEMSconnect.com.
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Permalink Reply by Cody W. Nelson on
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Used once to stabilize bilateral femurs. We didn't inflate the abdomen. They worked in that instance. We don't carry them any longer, though. I actually saw a couple of students place them on another student and inflate legs and abdomen before I could get to them and start removing them slowly from the student that instantly developed a headache. I haven't been a big fan of MAST.
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Permalink Reply by B Small on
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I don't worry about the good/bad debate of mast pants. They were the thing to use when I first started years ago then went out of style. Now research is saying tey are in again. That being said, I have used them one time on a major trauma 35 to 40 miles from the nearest trauma center. It did help the pt vital signs for a few minutes ,until he coded waiting for the helicopter. I would not hesitate to use them again given a similar situation,and would use them as a splint if that was all I had.
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Permalink Reply by Kimberly A Bownas on
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We have them and the big thing that I was told is that if you do use them make sure the ER doesn't cut them off the patient. When I took the EMT class the first time, we were shown how to use them. When I tried again we weren't taught anything about them. We were told that they are not even used anymore. Like I said we have them but we don't use them. Train hard and stay safe...
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If the patient died prior to transport, what good were the MAST?
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Permalink Reply by Jared Ryker on
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We dont carry them we pulled them off the trucks when they all dry rotted. but yes a big pain
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Permalink Reply by Doc82 on
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PASG/MAST based on where you are from or what you knew them as have been shown to cause more harm than good. The really only use we teach here is for splinting "open book" pelvic fractures, however, with the advent of the SAM pelvic sling we have stopped teaching the use of MAST all together. Some of our front line units still carry them, and some of the older medics still like to have them around, but they are almost never used. Most nurses dont even bother looking to see if they can be removed w/o being cut off, so ones that are used are rarely returned to service, which has been another contributing factor in the decline of use.
Also the increasing use of permissive hypotension has somewhat effectively removed the MASTs intended effect of forcing blood back into the core to ensure perfusion.
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