How to Remove and Deflate a Pneumatic Anti-Shock Garment ›Perform hand hygiene and don PPE as appropriate ›Identify the patient according to facility protocol ›Establish privacy by closing the door to the patient’s room and/or drawing the curtain surrounding the patient’s bed ›Introduce yourself to the patient and family member(s), if present; explain your clinical role in the deflation and removal of a PASG; assess the anxiety level of the patient/family and for knowledge deficits and anxiety regarding removal of the PASG •Determine whether the patient/family requires special considerations regarding communication (e.g., due to illiteracy, language barriers, or deafness); make arrangements to meet these needs, if present –Use professional certified medical interpreters, either in person or via telephone, when language barriers exist •Explain the procedure and its purpose; answer any questions and provide emotional support as needed ›Maintain in-line spinal immobilization at all times, if indicated ›Deflate the PASG as ordered when the patient has stabilized or if a complication develops. Perform the following steps to deflate the PASG: •Assess and document the patient’s vital signs, hemodynamic status, and level of consciousness before initiating deflation •Gradually deflate the abdominal compartment while monitoring and documenting the patient’s vital signs –If the SBP drops more than 5 mm Hg or the heart rate increases by 10 beats/min or more, deflation should be halted and I.V. fluids should be administered, as ordered. If the patient’s SBP is not restored, the abdominal compartment should be reinflated •Pause for 5 minutes or per facility/unit specific protocol •Gradually deflate one of the leg compartments while monitoring and documenting the patient’s vital signs –If one of the legs is injured, the compartment containing the uninjured leg should be deflated first –If the SBP drops more than 5 mm Hg or the heart rate increases by 10 beats/min or more, deflation should be stopped and I.V. fluids should be administered, as ordered. If the SBP is not restored, the leg compartment should be reinflated •Pause for 5 minutes or per facility/unit specific protocol •Gradually deflate the other leg compartment while monitoring and documenting the patient’s vital signs –If the SBP drops more than 5 mm Hg or the heart rate increases by 10beats/min or more, deflation should be stopped and I.V. fluids should be administered, as ordered. If the SBP is not restored, the leg compartment should be reinflated •Monitor the patient’s vital signs closely. Sudden and severe hypotension can occur ›Do not remove the PASG until ordered. Rapid reinflation may be necessary if the patient becomes unstable •To remove the PASG, release the Velcro closures; do not use scissors •Use the long spine board or scoop stretcher to log-roll the patient if immobilization is necessary ›Discard used procedure materials appropriately; perform hand hygiene ›Update the patient’s plan of care, as appropriate, and document the following information in the patient’s medical record: •Date and time of PASG deflation and removal •Description of the procedure, including amount of supplemental oxygen administered, type and amount of I.V. fluids and blood products infused, and any medications administered •Patient assessment information (and the time each element was assessed)regarding –vital signs –level of pain/anxiety/consciousness –pulse oximetry readings •Patient’s response to use of the PASG •Any unexpected outcomes and the interventions performed •All patient/family teaching