Avoid rough handling of the victim, and
transport to a medical treatment facility.
If transportation to a definitive care facility will
be lengthy or delayed, seek the radio or phone
advice of a medical officer on whether to give
fluids by mouth or to start an intravenous line. If
this consultation is impossible, use your own
judgment. In the case of cardiogenic shock, DO
NOT start intravenous fluids since blood volume
is sufficient and only function is impaired.
Constantly monitor the patient and record vital
signs every 15 minutes so that you are able to
keep track of the patient’s progress.
PNEUMATIC COUNTER-PRESSURE
DEVICES (MAST)
Commonly known as Medical Anti-Shock
Trousers or Military Anti-Shock Trousers (MAST),
pneumatic counter-pressure devices are designed to
correct or counteract certain internal bleeding
conditions and hypovolemia. The garment does this by
developing an encircling pressure up to 120 mm Hg
around both lower extremities, the pelvis, and the
abdomen. The pressure created
slows or stops venous and arterial bleeding in
areas of the body enclosed by the pressurized
garment;
forces available blood from the lower body to the
heart, brain, and other vital organs;
prevents pooling of blood in the lower
extremities; and
stabilizes fractures of the pelvis and lower
extremities.
Some indications for use of the pneumatic
counter-pressure devices are when
systolic blood pressure is less than 80 mm Hg,
systolic blood pressure is less than 100 mm Hg
and the patient exhibits the classic signs of
shock, or
fracture of the pelvis or lower extremities is
present.
Although the only absolute contraindication in the
use of these devices is in the case of pulmonary edema,
other conditional contraindications include congestive
heart failure, heart attack, stroke, pregnancy,
abdominal evisceration, massive bleeding into the
thoracic cavity, and penetrating wounds where the
object is still impaled in the victim.
Application of the anti-shock garment is a simple
procedure, but it requires some important preliminary
steps. When the garment is laid out flat, ensure that
there are no wrinkles. If the patient is to remain
clothed, remove all sharp and bulky objects from the
patient’s pockets. Take vital signs before applying the
MAST garment. When applying the garment, inflate
sufficiently so the patient’s systolic blood pressure is
brought to and maintained at 100 mm Hg. Once the
garment is inflated, take the patient’s vital signs every
5 minutes. The garment should be removed only under
the direct supervision of a physician.
BREATHING AIDS
LEARNING OBJECTIVE:
Recognize
breathing aids and their uses.
As a Hospital Corpsman, you should become
familiar with the breathing aids that may be available
to help you maintain an open airway and to restore
breathing in emergency situations. Breathing aids
include oxygen, artificial airways, bag-valve mask
ventilator, pocket face mask, and suction devices.
USE OF OXYGEN (O2)
In an emergency situation, you will probably have
a size E, 650-liter cylinder of oxygen available. The
oxygen cylinder is usually fitted with a yoke-style
pressure-reducing regulator, with gauges to show tank
pressure and flow rate (adjustable from 0 to 15 liters
per minute). A humidifier can be attached to the
flowmeter nipple to help prevent tissue drying caused
by the water-vapor-free oxygen. An oxygen line can
be connected from the flowmeter nipple or humidifier
to a number of oxygen delivery devices that will be
discussed later.
When available, oxygen should be administered,
as described below, to cardiac arrest patients and to
self-ventilating patients who are unable to inhale
enough oxygen to prevent hypoxia (oxygen
deficiency). Hypoxia is characterized by tachycardia,
nervousness, irritability, and finally cyanosis.
It
develops in a wide range of situations, including
p o i s o n i n g , s h o c k , c r u s h i n g c h e s t i n j u r i e s ,
cerebrospinal accidents, and heart attacks.
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