MONITOR A CASUALTY FOR HYPOVOLEMIC SHOCK
Continue to monitor the casualty as you continue your evaluation and
treatment. If the casualty is able, he may drink water. Do not give any thing by mouth
to a patient who is nauseous, vomiting, or has an altered mental status.
a. Monitor Vital Signs. Continue to take the casualty's vital signs every 5
minutes until they return to normal; then take his vital signs every 15 minutes. Check
the casualty's capillary refill by pressing on his nails and observing the return of color
to the nail beds.
b. Monitor Level of Consciousness. Check the casualty's level of
consciousness every 5 to 15 minutes as you monitor his vital signs.
c. Monitor IV Flow Rate. If the casualty's blood pressure stabilizes with the
return of peripheral pulses, discontinue the IV and monitor the patient.
d. Record Treatment. Initiate a U.S. Field Medical Card on the casualty.
Record treatment procedures and vital signs on the card.
e. Apply Pneumatic Counterpressure Device (PCPD), If Applicable. If the
casualty is not responding to treatment for shock, medical anti-shock trousers (MAST)
are available, and their use is appropriate (paragraph 7-5), apply them using the
procedures given in paragraphs 7-6 through 7-8. Medical anti-shock trousers are
usually found in a battalion aid station or other medical treatment facility.
There is more than one type of MAST device. The MAST devices are also
called military anti-shock trousers.
DETERMINE IF MEDICAL ANTI-SHOCK TROUSERS SHOULD BE USED
Medical anti-shock trousers can be applied to a casualty showing signs
and symptoms of hypovolemic shock when the casualty is not responding to treatment
for shock or when the cause of shock is not known. The MAST can also be used to help
control internal bleeding in the abdomen or legs and to stabilize a fracture of the
pelvis. Some general rules for deciding if the MAST should be applied are given
a. The MAST can be used if the casualty has one of the following conditions
and no contraindications exist.
(1) Systolic blood pressure reading is less than 60 mmHg and other signs
and symptoms of hypovolemic shock are present. (The systolic is the higher number
of a blood pressure reading.)