Effectiveness of Non-pneumatic Anti-shock Garment (NASG) in Preventing Shock-related Morbidity and Mortality in Severe Hemorrhagic Shock

Abstract

Context: NASG is a first-aid-life-sustaining-device that supports the life of a patient in hemorrhagic shock during delays in receiving appropriate healthcare services by shunting blood from the lower body to the core organs. Objectives: To reappraisal the effectiveness of NASG in sustaining life, and preventing shock-related morbidity and mortality during obstetric delays and make recommendations. Method: The case notes of 4 patients that were managed with NASG in Enugu State University Teaching Hospital (ESUTH), Enugu from July 25, 2016 to April 3, 2017 were reviewed and the results presented in tables and percentages. Results: The mean age and parity of the patients were 31.8 years and 3.5 respectively. They presented in severe hemorrhagic shock with 2/4 (50%) unconscious, 2/4 (50%) pulseless, and low mean arterial pressures. The two unconscious patients became conscious with the restoration of pulses on the application of NASG. The vital signs of the patients improved when the causes of shock were properly treated. Uterine rupture ¾ (75%), vaginal lacerations 1/4(20%) and cervical tear ¼ (25%) accounted for the hemorrhagic shock in this reappraisal. A total of 23 pints of blood were transfused. All the patients survived and none had shock-related morbidity. Conclusions: This reappraisal has confirmed the effectiveness of NASG in preventing shock-related complications during obstetric delays. The causes of the shock must be identified and properly treated to optimize its effectiveness. NASG should be available in every childbirth center.