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July 23, 1982

Use of the Pneumatic Antishock Garment

JAMA. 1982;248(4):428-429. doi:10.1001/jama.1982.03330040022019

To the Editor.—  The MEDICAL NEWS section contained a report entitled "One Caution in Pneumatic Antishock Garment Use" (1982;247:1112). We have doubts about the conclusion and recommendations of this report.A forensic pathologist is reported as indicating that an antishock garment application may have caused a massive fatal postpartum air embolism in a woman with placenta accreta. The woman delivered at home and began hemorrhaging after the birth of a normal-term baby. The husband started cardiopulmonary resuscitation and later called emergency medical technicians, who arrived about an hour after the birth.Seven minutes after her vital signs were no longer detectable, while en route to the hospital, the emergency medical technicians applied the pneumatic antishock garment to the patient. She was eventually pronounced dead at the receiving hospital. At autopsy, the pathologist determined the mechanism of death to be a massive air embolus. He theorized that the air embolus entered