A Pilot Study of Proactive Team REBOA to Avoid Delays to Definitive Care

Abstract

As experience using resuscitative endovascular balloon occlusion of the aorta (REBOA) has expanded over the past few years, best practices for implementing a REBOA program have emerged. Early practice was single-surgeon focused, but we have learned that a team approach to REBOA practice is common in successful programs. Key components of our contemporary team approach are defining a patient selection algorithm, uniform acceptance of early CFA access, full team training, regular case reviews, and implementation of a process improvement program. This team approach to REBOA has resulted in numerous benefits for trauma patients with, most importantly, a significantly decreased time to definitive hemorrhage control. Here, we describe our experience and outcomes as a Level 1 Trauma Center implementing a REBOA program, shifting our hemorrhage control paradigm from reactive to proactive, and subsequently improving time to both temporary and definitive hemorrhage control maneuvers.