Use of an improvised pneumatic anti-shock garment and a non-pneumatic anti-shock garment to control pelvic blood flow

Abstract

BackgroundPelvic bleeding from trauma and postpartum hemorrhage is often difficult to treat successfully by emergency providers particularly in low resource environments, when hospital presentation is delayed or there is a lack of immediate surgical, anesthesia, and transfusion capabilities. Pneumatic anti-shock garments (PASG) decrease pelvic blood flow and hemorrhage. A tightly fitted neoprene non-pneumatic anti-shock garment (NASG) has been shown to decrease blood loss and improve survival rates from postpartum hemorrhage.AimsThe objective of this study was to determine whether blood flow to the pelvis is decreased by use of the NASG or by an improvised PASG.MethodsA PASG was made using three bicycle tubes, placing one tube on each leg and one on the lower abdomen/pelvis, wrapping firmly with sheets and inflating the tubes to approximately 3.5 bar (45 psi). A Doppler ultrasound was used to measure distal aortic blood flow in 12 healthy adults at baseline and in both devices. Data were analyzed with one sample and paired t tests.ResultsMean flow was 1.99 l/min at baseline. Mean flow decrease was 1.11 [95% confidence interval (CI): 0.64–1.57, p = 0.0003 for the difference] for the PASG and 0.65 (95% CI: 0.03–1.26, p = 0.04) for the NASG. The PASG decreased blood flow more than the NASG (mean difference: 0.46, 95% CI: 0.02–0.90, p = 0.04).ConclusionsBoth devices decreased distal aortic blood flow, but the improvised PASG device decreased it by a larger margin.