MAST pants

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"1.    Does your region or hospital still have MAST  available, either
in 
the EMS, helicopters or your EC?"

No.

"2.    Do you teach the use of MAST in any of your  resuscitation
courses 
(ATLS, ACLS, PALS, etc)"

We teach actively AGAINST it in all three courses, plus TNCC.  Can't
speak offhand for PHTLS, ATOM, etc.

"3.    In the continuing bleeding patient [who] has received  blood, LR,
NS, 
and has a know fractured pelvis, upon which someone else has  placed
MAST 
pants, do you remove them in the EC, OR, ICU, where?"

Hasn't come up in years.  Hypothetically, would most likely be removed
in the ED, if not before.

"4.    What do you know or teach about the removal of MAST  pants, 
recognizing you might see them only once a year or once a decade?"

a) If you don't apply them, nobody has to worry about removing them.
b) The standard teaching would be for a staged deflation, compartment by
compartment, with recheck of vitals at each stage.  After deflation, cut
them off with crash shears.

"5.    Would you or anyone in your hospital ever just cut  them off in
such 
a transferred patient arriving in your EC?"

Okay.  Honestly?  Probably not, although there's plenty of
justification.  More likely we'd leverage the teachable moment in real
time ("Hey, guys.  Do you want us to throw these away, being that you
should never use them again?  Let's have a cup of coffee and go over
why.").  Scissors are for shock value (pun intended), which has its
occasional downside.

6.    Who would make the decision to remove the MAST pants -  paramedic,
EC 
doctor, EC nurse,  trauma surgeon, ICU doctor, anesthesia, OR  nurse,
just 
who and where?

If it is practicable, this should of course be a prescriptive event, as
with application or removal of any medical device not otherwise covered
by protocol.  But then, we have the advantage of a huge and like-minded
pool of clinicians.  It's not likely that a nurse or medic would be
criticized for acting independently in this regard; but such
independence is unnecessary in our system.

Pret Bjorn, RN
Bangor, ME USA


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