REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta)

Objectives

To provide guidance for (a) the indications for REBOA; and (b) the performance of REBOA within the deployed setting for patients with non-compressible haemorrhage who require Damage Control Surgery

Scope

These guidelines are for deployed clinicians who manage patients who require Damage Control Surgery for non-compressible haemorrhage.

Audience

All clinicians within the deployed setting (including surgeons, anaesthetists, Intensive Care Unit providers, nursing staff and perioperative practitioners) who may be required to either deliver REBOA capability or look after patients who have had REBOA placed already.

Initial Assessment & Management

Initial assessment and management within the deployed setting depends on the number of simultaneous casualties with non-compressible torso haemorrhage (NCTH). 

Advanced Assessment & Management

Before REBOA is delivered, surgical facilities must be able to:

• Offer patients Damage Control Surgery within the REBOA balloon inflation timeline
• Have sufficient remaining DCR resources to manage REBOA patients throughout the care pathway
• Have skill-set to perform REBOA and anticipate/manage complications safely

Prolonged Casualty Care

REBOA is not appropriate for prolonged casualty care if it is not followed by DCS within the balloon inflation timelines. 

Paediatric Considerations

There are no indications for use of REBOA for Paediatric patients