Hemorrhage is the leading cause of mortality in trauma. New and emerging technologies and devices are broadening the trauma resuscitationists’ toolbox to control a variety of challenging bleeding injuries. The basic tenets of managing massive bleeding are hemorrhage control and hemostatic resuscitation; this chapter will focus on hemorrhage control. Strategies for both compressible and non-compressible bleeding are discussed, including junctional hemorrhage. The breadth of applications using resuscitative endovascular balloon occlusion of the aorta (REBOA) are addressed, including program implementation, partial REBOA, vena cava occlusion, and non-trauma applications. Use of tourniquets, hemostatic products, and techniques for wound packing is also described. Familiarity with breadth of hemorrhage control options will allow the trauma team to initiate hemorrhage control and mobilize appropriate resources to optimize patient care.

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REBOA and Novel Hemorrhage Control Methods

  • Nori L. Bradley,
  • Shaun Cowan,
  • Megan Brenner

摘要

Hemorrhage is the leading cause of mortality in trauma. New and emerging technologies and devices are broadening the trauma resuscitationists’ toolbox to control a variety of challenging bleeding injuries. The basic tenets of managing massive bleeding are hemorrhage control and hemostatic resuscitation; this chapter will focus on hemorrhage control. Strategies for both compressible and non-compressible bleeding are discussed, including junctional hemorrhage. The breadth of applications using resuscitative endovascular balloon occlusion of the aorta (REBOA) are addressed, including program implementation, partial REBOA, vena cava occlusion, and non-trauma applications. Use of tourniquets, hemostatic products, and techniques for wound packing is also described. Familiarity with breadth of hemorrhage control options will allow the trauma team to initiate hemorrhage control and mobilize appropriate resources to optimize patient care.