shock trousers

shock trousers,

a pneumatic garment designed to produce pressure on the lower part of the body, thereby preventing the pooling of blood in the legs and abdomen. The shock trousers are used when the patient loses consciousness, has a decreased or falling blood pressure, and shows signs of respiratory distress, such as dyspnea; rapid breathing; a cough; and pink, frothy sputum. Shock trousers combat shock and splint or stabilize pelvic fractures, promote hemostasis, increase peripheral vascular resistance, and permit autotransfusion of small amounts of blood. They also are used in emergencies in the treatment of hemorrhagic shock. Shock trousers are contraindicated in patients with pulmonary edema, cardiogenic shock, increased intracranial pressure, or eviscerations.

method Before the pressurized trousers are applied, they are checked for tears or leaks and the proper functioning of their valves; any kinks or twists in the tubes connecting the trousers to the pneumatic pump are removed. The patient is placed in a flat, supine position over the open trousers, and the leg sections and part that encircles the abdomen just below the rib cage are firmly secured in place by closing the self-adhesive (Velcro) straps or zippers. The exact times at which the trousers' sections are inflated are recorded, and the inflated sections are checked every 15 minutes. The patient's blood pressure, respiration, and apical and peripheral pulses also are checked every 15 minutes, and chest sounds are auscultated hourly. The leg pulses may be diminished or absent, and the feet may appear pale, mottled, and cold. Parenteral fluids, whole blood, plasma protein fractions, and other plasma volume expanders are administered as ordered; the flow rate of expanders is adjusted according to central venous pressure readings. An indwelling urethral catheter is connected to a closed gravity drainage system, and fluid intake and output are measured hourly. If less than 30 mL of urine per hour is excreted, renal failure may occur. Monitoring of blood gases and intermittent suctioning through a nasogastric tube may be ordered. The trousers are not deflated or removed until the blood volume replacement is stable and the patient's physician is in attendance. As each section of the trousers, starting with the abdominal section, is gradually deflated, the patient's blood pressure, respiration, and apical pulse are checked every 5 to 10 minutes. If the blood pressure drops 4 to 6 mm Hg, deflation is stopped.

interventions The nurse checks, applies, and inflates the shock trousers and remains with the patient during the entire procedure. The vital signs are monitored at frequent intervals, parenteral fluids and plasma volume expanders are given, measures of the intake and output are taken and recorded, and emotional support is provided. Also called antishock garment, military antishock trousers, pneumatic antishock garment.