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Use of the pneumatic anti-shock garment
  1. R Owen,
  2. N Castle
  1. Department of Emergency Medical Care and Rescue, Durban University of Technology, Durban, Natal, South Africa
  1. Mr R Owen, National Primary Care Research and Development Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK; robert.owen{at}

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KwaZulu-Natal, South Africa, operates a tiered emergency medical service and hospitals are graded according to the type of patient they can receive. The incidence of trauma is high and, owing to the mixed urban-rural population in KwaZulu-Natal, prolonged prehospital and interhospital transfer times are common.


An adult male with an abdominal gunshot wound had been taken to a rural clinic by relatives. The clinic had no resident surgeons and therefore a road transfer of at least 45 min to a trauma unit was required.

  • A: Clear.

  • B: Respiration >28 breaths/min: no Spo2 trace was detectable.

  • C: Weak carotid pulse (100 beats/min), blood pressure (BP) unrecordable.

  • D: Unresponsive.

  • E Abdominal gunshot wound (level with the umbilicus) with no exit wound.

A 250 ml fluid challenge was administered but the absence of any response prompted a second fluid bolus and the application of the pneumatic anti-shock garment (PASG).

Following the fluid challenges …

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  • Funding: None.

  • Competing interests: None.