OB Hemorrhage: Anti-Shock Garments

Non-Pneumatic (NASG) and Pneumatic (PASG) Garments

Suellen Miller, PHD, CNM, MHA 

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco

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Summary

The non-pneumatic anti-shock garment (NASG) is a first-aid device that reverses hypovolemic shock and decreases obstetric hemorrhage. It consists of articulated segments of neoprene, which closes tightly with Velcro, shunting blood from the lower body to the core organs, elevating blood pressure and increasing preload and cardiac output. The NASG is not an FDA approved device, but did receive a 510(k) equivalent device FDA clearance, based on its similarity to the Pneumatic Anti-Shock Garment (PASG, aka, MAST suit). Theoretically all anti-shock garments work on the same principles, as a compression suit, which upon placement to a hypovolemic person restores blood pressures—particularly to the core—by returning blood from the lower body.

The NASG is easier to use than the PASG but it has limited experience and availability.  Of the two, NASG will be the type used in the future, but there are still important issues to settle including cleaning and re-usability.  The initial use of the PSAG for postpartum hemorrhage is summarized in Table 1 below.

                     Table 1: Use of PSAG for Postpartum Hemorrhage

See the full document for much more information and discussion about  promising time series trials of the NASG in Africa and a case report from California.