Re: PASG pants -- PHTLS Update

[Guest guest]

Thank you, , for this summary. You are correct, I believe.

However, I continue to ask the question until somebody answers it: Where is

the scientific proof that PASG has any positive influence on patient outcomes?

I recall that an NAEMSP position paper formed the basis for the statement that

" in the following three conditions the PASG MAY (emphasis mine) have SIGNIFICANT

BENEFIT (emphasis mine) in patients with blood loss (in three different

situations) ...... " That position paper was not supported by any studies that

I know of, and it is now several years old.

I continue to maintain that there is no scientific proof to support that

statement. And taken on its face, it's a weak endorsement at best. " May have

significant benefit " is pure speculation.

When will we decide that what we do for our patients will be driven by evidence,

not conjecture? Of course, if that notion were to invade medicine, half the

things doctors do would have to be abandoned.

GG

Re: PASG pants -- PHTLS Update

Yes, there was a PHTLS Instructor Update in Dallas on Monday, Sept 26 for 8

hours. They gave us a draft copy of the new textbook which is not complete. It

was very informational. They will be holding additional Updates; Texas Updates

will be scheduled by Lee , Texas Coordinator. I may be mistaken but I

believe they are considering online/internet version as a possible venue for

some of the Updates. This was not in stone.

Those who attended the Update will receive the new textbook. There will be

minimal changes involving the Instructor Manual. I do not believe it will be

reprinted.

You are not to teach the new material until you have attended an Update and new

materials are out. If I remember correctly the deadline for your Update is June

2011.

If you need additional information, I will consult my notes.

PASG is listed in the Draft 7th Edition textbook as " controversial " . However,

" in the following three conditions the PASG may have significant benefit in

patients with shock from blood loss:

1. Suspected pelvic fractures with hypotension (systolic blood pressure of 90

mm Hg). Inflate entire PASG.

2. Suspected intraperitoneal hemorrhage with hypotension. Inflate entire PASG.

3. Suspected retroperitoneal hemorrhage with hypotension. Inflation of the

entire device compresses the retroperitoneal organs. "

" The PASG is probably significantly less effective than direct pressure or a

pressure dressing with guaze and an elastic bandage for control of external

hemorrhage from the extremities. "

I will list the Contraindications listed in the Draft textbook without their

explanations on Pg 202:

1) " Penetrating thoracic trauma

2) Splinting of lower extremity fractures

3) Evisceration of abdominal organs

4) Impaled objects in the abdomen

5) Pregnancy

6) Traumatic cardiopulmonary arrest

7) Co-existing medical conditions

Congestive heart failure (CHF)

Pulmonary edema "

I hope this was helpful.

Have a great week!

County ESD-1

Work Email: dwilliams@...

Cell Phone:

RE: PASG pants

It will be interesting to see if it is in the new PHTLS curriculum. Does

anyone know?

Jane Dinsmore