A Low-Cost Insertion Trainer for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure designed to treat non-compressible torso hemorrhage. Because this is a high-acuity low-occurrence event, it is difficult to train providers on the procedure and difficult for trained providers to stay proficient. Our primary objective was to develop a low-cost, high-fidelity teaching model to increase emergency medicine (EM) resident knowledge, confidence, and proficiency in performing REBOA. We utilized readily available materials to allow for ease of replication and cost-effectiveness. The aorta was simulated by a bicycle tire inner tube, and the femoral artery was simulated by natural rubber tubing. Once connected, these simulated vascular structures were threaded through a plastic torso mold and filled with simulated blood. Participants then performed the REBOA procedure with very little time required for reset between participants. After completing the training using our model, participants completed a survey rating aspects of the session on a five-point Likert scale. Participants included 21 EM residents from all levels of training. Participants rated the fidelity of the REBOA insertion trainer very highly (mean = 4.05, SD 0.67) and felt that the training was overall very useful (mean = 4.29, SD 0.56). Comments regarding the model were universally positive. We present a novel low-cost REBOA task trainer that is easy to build, reusable, and portable, and can be utilized either in a hospital or austere training environment.