NASG Research & Clinical Studies
Non-Pneumatic Anti-Shock Garment
Obstetric hemorrhage is the leading cause of maternal mortality, particularly in low resource settings where delays in obtaining definitive care contribute to high rates of death. The non-pneumatic anti-shock garment (NASG) first-aid device has been demonstrated to be highly cost-effective when applied at the referral hospital (RH) level.
WHO Recommendations for the the prevention and Treatment of postpartum haemorrhage
“In our research, women who appeared clinically dead, with no blood pressure and no palpable pulse, were resuscitated and kept alive for up to two days [using the NASG] while waiting for blood transfusions.”
CNM, PhD, international maternal health expert and director of the Safe Motherhood Programs of the University of California, San Francisco Women’s Global Health Imperative.
Clinical Research and Case Studies:
- Hensleigh PA (2002) Anti-Shock garment provides resucitation and haemostasis for obstetric haemorrhaging. BJOG 109:1377-1384
- El Ayadi, A; Butrick, E; Geissler, J; Miller, S. (2013) Combined Alnalysis of the Non-pneumatic Anti-Shock Garment on mortality from Hypovolemic Shock Secondary to Obstetric Hemorrhage. BMC Pregnancy & Childbirth: 13(208)/ University of California
- WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage.
- Barriers and Facilitators to Scaling Up the Non-Pneumatic Anti-Shock Garment for Treating Obstetric Hemorrhage: A Qualitative Study. Jordan K; Butrick E; Yamey G; Miller S. (2016) PLoS ONE 11(3): e0150739.
- The Role of the Nonpneumatic Antishock Garment in Reducing Blood Loss and Mortality Associated with Post-Abortion Hemorrhage. Manandhar S; El Ayadi AM; Butrick E; Hosang R; Miller S. (2015) Studies in Family Planning; 46(3):281-96.
- A promising device to save maternal lives associated with obstetrics hemorrhage: the non-pneumatic anti-shock garment (NASG). Miller S; Belizan JM. (2015) Reproductive Health; 12:26.
- Non-pneumatic anti-shock garment for improving maternal survival following severe postpartum haemorrhage: a systematic review. Pileggi-Castro C; Nogueira-Pileggi V; Tuncalp O; Oladapo OT; Vogel JP; Souza JP. (2015) Reproductive Health; 12:28.
- Cost-effectiveness of the non-pneumatic anti-shock garment (NASG): evidence from a cluster randomized controlled trial in Zambia and Zimbabwe.Downing J; El Ayadi A; Miller S; Butrick E; Mkumba G; Magwali T; Kaseba-Sata C; Kahn JG. (2015) BMC; 15:37.
- Non-pneumatic anti-shock garment to stabilize women with hypovolemic shock secondary to obstetric hemorrhage.FIGO Safe Motherhood and Newborn Health Committee. (2014) IJGO; 128: 194-195.
- Per-protocol Effect of Earlier Non-pneumatic Anti-Shock Garment Application for Obstetric Hemorrhage. El Ayadi, A; Gibbons, L; Bergel, E; Butrick, E; Huong, MT, N.Y; Mkumba, G; Kaseba, C; Magwali, T; Merialdi, M; Miller, S. (2014) IJGO; 126(1): 95–96.
- Non-pneumatic Anti-Shock Garment (NASG), a First-Aid Device to Decrease Maternal Mortality from Obstetric Hemorrhage: A Cluster Randomized Trial.Miller, S; Bergel, EF; El Ayadi, A; Gibbons, L; Butrick, E; Magwali, T; Mkumba, G; Kaseba, C; My Huong, NT; Geissler, JD; Merialdi, M.(2013) PLOS ONE; 8(10): e76477.
- Use of the Non-pneumatic Anti-Shock Garment (NASG) for Life-Threatening Obstetric Hemorrhage: A Cost-Effectiveness Analysis in Egypt and Nigeria.Sutherland, T; Downing, J; Miller, S; Bishai, DM; Butrick, E; Fathalla, MF; Mourad-Youssif, M; Ojengbede, O; Nsima, D; Kahn, JG. (2013) PLOS ONE; 8(4):e62282.
- Nurses in Low Resource Settings Save Mothers’ Lives with the Non-pneumatic Anti-Shock Garment. Kausar, F; Morris, J; Fathalla, M; Ojengbede, O; Fabamwo, A; Mourad-Youssif; Morhason-Bello, IO; Galadanci, H; Nsima, D; Butrick, E; Miller, S. (2012) MCN – The American Journal of Maternal / Child Nursing; 37(5):308-16.
History of the Non-Pneumatic Anti-Shock Garment. (From WikiPedia)
In the 1900s an inflatable pressure suit was developed by George Crile. It was used to maintain blood pressure during surgery. In the 1940s and after undergoing numerous modifications, the suit was refined for use as an anti-gravity suit (G-suit). Further modification led to its use in the Vietnam War for resuscitating and stabilizing soldiers with traumatic injuries before and during transportation. In the 1970s the G-suit was modified into a half-suit which became known as MAST (Military anti-shock trousers) or PASG (Pneumatic Anti-Shock Garment). During the 1980s the PASG garment became used more and more by emergency rescue services to stabilize patients with shock due to lower body hemorrhage. During the 1990s the PASG was added to the American College of Obstetrics and Gynecology, making it part of the recommended treatment for use by obstetricians and gynecologists in the USA. However, it was removed from the guidelines later and is no longer on the ACOG guidelines.
From the 1970s, NASA/Ames was involved in developing a non-pneumatic version of the anti-shock garment. This was originally used for hemophiliac children, but has since been developed into the garment known as the Non-pneumatic Anti-Shock Garment (NASG).
The non-pneumatic anti-shock garment is now off-patent and produced in several different locations.
The use of the garment for obstetrical hemorrhage in low-resource settings began in 2002 when Dr. Carol Brees and Dr. Paul Hensleigh introduced the garment into a hospital in Pakistan and reported on a case series of its use.
Suellen Miller and colleagues in Mexico, Egypt and Nigeria have completed studies of the NASG (also named the LifeWrap) for obstetric hemorrhage in hospitals in these countries with studies ongoing at primary health care centers in Zambia and Zimbabwe.