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Thu, 21 Nov 2002 08:18:55 -0600

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That remembers me the study that you and Paul Pepe, M.D. did about it.
Alejandro Cabrera, M.D.
Medical dierctor.
SPE ALS ambulance services.
Guadalajara, Mexico.
  ----- Original Message -----=20
  From: KMATTOX@aol.com=20
  To: trauma-list@trauma.org=20
  Sent: Saturday, November 16, 2002 8:27 AM
  Subject: Device Compared to MAST

  In a message dated 11/15/2002 6:30:33 PM Central Standard Time, =
Debbie.Perrin-Davis@advocatehealth.com writes:

    >What is the name of the device that is being compared to MAST???

  A simple bed sheet wrapped around the pelvis has been proposed by many =
orthopedic surgeons, including some from the Mass General Hospital.   A =
commercial device is simplier, but more expensive.    I would certainly =
hope that NOTHING is compared to MAST as MAST has virtually NO value.  =
The early papers that suggested value in pelvic fractures, contained =
very few cases, and basically no controls.   =20

  If I had ONE major suggestion regarding pelvic fractures and bleeding, =
it would be to keep the venous and arterial pressures lowish and do not =
give more than 500 ml crystalloid, which has been shown at these levels =
to dilute out clotting factors and creates an iatrogenic coagulopathy.   =
 And finally external fixators have no controled studies to show that =
they are of value in controlling pelvic fracture bleeding.    The papers =
on external fixators are Class 5 data-WAG, or Class 4 data, SWAG at =
least.   =20

  k=20

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<BODY bgColor=3D#ffffff>
<DIV><FONT face=3DArial size=3D2>That remembers me the study that you =
and Paul Pepe,=20
M.D. did about it.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Alejandro Cabrera, M.D.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Medical dierctor.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>SPE ALS ambulance =
services.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Guadalajara, Mexico.</FONT></DIV>
<BLOCKQUOTE=20
style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
  <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
  <DIV=20
  style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
  <A title=3DKMATTOX@aol.com =
href=3D"mailto:KMATTOX@aol.com">KMATTOX@aol.com</A>=20
  </DIV>
  <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
  href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Saturday, November 16, =
2002 8:27=20
  AM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Device Compared to =
MAST</DIV>
  <DIV><BR></DIV><FONT face=3Darial,helvetica><FONT lang=3D0 =
face=3DArial size=3D2=20
  FAMILY=3D"SANSSERIF">In a message dated 11/15/2002 6:30:33 PM Central =
Standard=20
  Time, <A=20
  =
href=3D"mailto:Debbie.Perrin-Davis@advocatehealth.com">Debbie.Perrin-Davi=
s@advocatehealth.com</A>=20
  writes:<BR><BR>
  <BLOCKQUOTE=20
  style=3D"PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #0000ff 2px =
solid; MARGIN-RIGHT: 0px"=20
  TYPE=3D"CITE">&gt;What is the name of the device that is being =
compared to=20
    MAST???<BR></BLOCKQUOTE><BR><BR>A simple bed sheet wrapped around =
the pelvis=20
  has been proposed by many orthopedic surgeons, including some from the =
Mass=20
  General Hospital.&nbsp;&nbsp; A commercial device is simplier, but =
more=20
  expensive.&nbsp;&nbsp;&nbsp; I would certainly hope that NOTHING is =
compared=20
  to MAST as MAST has virtually NO value.&nbsp; The early papers that =
suggested=20
  value in pelvic fractures, contained very few cases, and basically no=20
  controls.&nbsp;&nbsp;&nbsp; <BR><BR>If I had ONE major suggestion =
regarding=20
  pelvic fractures and bleeding, it would be to keep the venous and =
arterial=20
  pressures lowish and do not give more than 500 ml crystalloid, which =
has been=20
  shown at these levels to dilute out clotting factors and creates an =
iatrogenic=20
  coagulopathy.&nbsp;&nbsp;&nbsp; And finally external fixators have no=20
  controled studies to show that they are of value in controlling pelvic =

  fracture bleeding.&nbsp;&nbsp;&nbsp; The papers on external fixators =
are Class=20
  5 data-WAG, or Class 4 data, SWAG at least.&nbsp;&nbsp;&nbsp; =
<BR><BR>k</FONT>=20
  </FONT></BLOCKQUOTE></BODY></HTML>

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Device Compared to MAST