Clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA, 2019: a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians

Eileen M Bulger¹, Debra G Perina², Zaffer Qasim³, Brian Beldowicz⁴, Megan Brenner⁵, Frances Guyette⁶, Dennis Rowe⁷, Christopher Scott Kang⁸, Jennifer Gurney⁹, Joseph DuBose¹⁰, Bellal Joseph¹¹, Regan Lyon¹², Krista Kaups¹³, Vidor E Friedman¹⁴, Brian Eastridge¹⁵, Ronald Stewart¹⁵

Affiliations

¹ Department of Surgery, University of Washington, Seattle, Washington, USA.
² Department if Emergency Medicine, University of Virginia, Charlottesville, Virginia, USA.
³ Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Department of Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
⁵ Department of Surgery, University of California Riverside, Riverside, California, USA.
⁶ Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁷ Government and Industry Relations, Priority Ambulance Inc, Knoxville, Tennessee, USA.
⁸ Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Washington, USA.
⁹ Joint Trauma System, Defense Center of Excellence, San Antonio, Texas, USA.
¹⁰ Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹¹ Department of Surgery, University of Arizona, Tucson, Arizona, USA.
¹² Department of Emergency Medicine, Uniformed Services University of the Health Sciences, Graduate School of Nursing, Bethesda, Maryland, USA.
¹³ Department of Surgery, University of California San Francisco, Fresno, California, USA.
¹⁴ Emergency Medicine, Florida Emergency Physicians, Maitland, Florida, USA.
¹⁵ Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.

PMID: 31673635
PMCID: PMC6802990
DOI: 10.1136/tsaco-2019-000376

Clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA, 2019: a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians

Eileen M Bulger et al. Trauma Surg Acute Care Open. 2019.

. 2019 Sep 20;4(1):e000376.

doi: 10.1136/tsaco-2019-000376. eCollection 2019.

Authors

Affiliations

¹ Department of Surgery, University of Washington, Seattle, Washington, USA.
² Department if Emergency Medicine, University of Virginia, Charlottesville, Virginia, USA.
³ Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Department of Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
⁵ Department of Surgery, University of California Riverside, Riverside, California, USA.
⁶ Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁷ Government and Industry Relations, Priority Ambulance Inc, Knoxville, Tennessee, USA.
⁸ Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Washington, USA.
⁹ Joint Trauma System, Defense Center of Excellence, San Antonio, Texas, USA.
¹⁰ Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹¹ Department of Surgery, University of Arizona, Tucson, Arizona, USA.
¹² Department of Emergency Medicine, Uniformed Services University of the Health Sciences, Graduate School of Nursing, Bethesda, Maryland, USA.
¹³ Department of Surgery, University of California San Francisco, Fresno, California, USA.
¹⁴ Emergency Medicine, Florida Emergency Physicians, Maitland, Florida, USA.
¹⁵ Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.

PMID: 31673635
PMCID: PMC6802990
DOI: 10.1136/tsaco-2019-000376

Abstract

This is a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians regarding the clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA. This statement addresses the system of care needed to manage trauma patients requiring the use of REBOA, in light of the current evidence available in this patient population. This statement was developed by an expert panel following a comprehensive review of the literature with representation from all sponsoring organizations and the US Military. This is an update to the previous statement published in 2018. It has been formally endorsed by the four sponsoring organizations.

Keywords: Shock resuscitation; endovascular treatment; shock management.

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Conflict of interest statement

Competing interests: MB reports royalties from Prytime Medical Inc as a member of the Clinical Advisory Board. In addition, MB has a patent for a 'Central Pressurized Cadaver Model' pending. MB is also the founder and committee chair of the Basic Endovascular Skills for Trauma (BEST) Course which is managed by the American College of Surgeons. She receives no financial income from the course. ZQ is the course medical director for the Resuscitation Adjuncts: Prehospital Transfusion and REBOA (RAPToR) course for which he provides medical direction but maintains no financial relationship with this course.

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