Haemorrhage Control

2002 ◽  
pp. 197-200
Author(s):  
Charles Cox
Keyword(s):  
Haemorrhage Control

Defence Medical Services’ REBOA training course

2021 ◽  
pp. bmjmilitary-2021-001926
Author(s):  
Max E R Marsden ◽  
C Park ◽  
J Barratt ◽  
N Tai ◽  
P Rees
Keyword(s):  
Training Programme ◽  
Balloon Occlusion ◽  
Medical Services ◽  
Skill Retention ◽  
Training Course ◽  
Challenges And Opportunities ◽  
Haemorrhage Control ◽  
Surgical Teams ◽  
The Uk ◽  
First Time

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) enables temporary haemorrhage control and physiological stabilisation. This article describes the bespoke Defence Medical Services (DMS) training package for effectively using REBOA. The article covers how the course was designed, how the key learning objectives are taught, participant feedback and the authors’ perceptions of future training challenges and opportunities. Since the inaugural training course in April 2019, the authors have delivered six courses, training over 100 clinicians. For the first time in the UK DMS, we designed and delivered a robust specialist endovascular training programme, with demonstrable, significant increases in confidence and competence. As a result of this course, the first DMS REBOA-equipped forward surgical teams deployed in June 2019. Looking to the future, there is a requirement to develop an assessment of skill retention and the potential need for revalidation.

Haemorrhage control in severely injured patients

The Lancet ◽  
2012 ◽  
Vol 380 (9847) ◽  
pp. 1099-1108 ◽  
Author(s):  
Russell L Gruen ◽  
Karim Brohi ◽  
Martin Schreiber ◽  
Zsolt J Balogh ◽  
Veronica Pitt ◽  
...  
Keyword(s):  
Severely Injured ◽  
Severely Injured Patients ◽  
Haemorrhage Control ◽  
Injured Patients

High-speed handling of a haemorrhage control system by first-responders and physicians

2020 ◽  
Vol 38 (4) ◽  
pp. 838-839
Author(s):  
Paul-Georges Reuter ◽  
Sarah Tepper ◽  
Hayatte Akodad ◽  
Antoine Lesecq ◽  
Camille Freedman ◽  
...  
Keyword(s):  
Control System ◽  
High Speed ◽  
First Responders ◽  
Haemorrhage Control

Haemorrhage control: lessons from the military

2013 ◽  
Vol 21 (7) ◽  
pp. 20-24 ◽  
Author(s):  
William Rowell
Keyword(s):  
Haemorrhage Control ◽  
The Military

scholarly journals Factor VIIa as an adjunct to standard haemorrhage control after blunt pelvic trauma

Injury Extra ◽  
2005 ◽  
Vol 36 (10) ◽  
pp. 416-417
Author(s):  
Duncan McAuley ◽  
Bethan Ellis ◽  
David Hodgkinson
Keyword(s):  
Factor Viia ◽  
Pelvic Trauma ◽  
Haemorrhage Control ◽  
Blunt Pelvic Trauma

Successful use of a military-grade haemostatic agent for a major head and neck bleed

2013 ◽  
Vol 127 (10) ◽  
pp. 1031-1033 ◽  
Author(s):  
R Crunkhorn ◽  
R Burnham ◽  
G Walton
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Parapharyngeal Space ◽  
Major Haemorrhage ◽  
Haemostatic Agent ◽  
Nerve Sheath ◽  
Haemostatic Agents ◽  
Haemorrhage Control ◽  
Life Threatening ◽  
The Military

AbstractBackground:Major haemorrhage is a catastrophic complication occurring in 3–4 per cent of head and neck cancer patients. Massive haemorrhage also causes 50 per cent of preventable deaths in combat situations. There has been a surge of interest in the development of effective haemostatic products in the military, with chitosan being one such product.Case report:A 48-year-old lady presented with a life-threatening head and neck bleed. She was known to have a malignant peripheral nerve sheath sarcoma originating from the left parapharyngeal space. Bleeding was successfully controlled with the application of Celox™ granules, a chitosan-based product currently used in the military.Conclusion:This paper describes the first known use of a military haemostatic agent to control a malignant head and neck bleed. Celox granules can be poured directly onto a wound to enhance haemorrhage control. The suggested mechanism of action and reports of current uses of haemostatic agents are described.

scholarly journals Intravascular ultrasound, performed during resuscitative endovascular balloon occlusion of the aorta (REBOA), confirms correct balloon deployment and haemostasis - a potential solution for remote, austere and military settings

2018 ◽  
Vol 104 (1) ◽  
pp. 12-17
Author(s):  
P S C Rees ◽  
A M Buckley ◽  
S A Watts ◽  
E Kirkman
Keyword(s):  
Intravascular Ultrasound ◽  
Guide Wire ◽  
Damage Control ◽  
Abdominal Ultrasound ◽  
Balloon Occlusion ◽  
Control Technique ◽  
Military Trauma ◽  
Haemorrhage Control ◽  
Potential Applicability ◽  
Endovascular Balloon Occlusion

AbstractIntroductionResuscitative endovascular balloon occlusion of the aorta (REBOA) is rapidly evolving as an emergency haemorrhage control technique. It has wide potential applicability in remote and austere settings, and following military trauma where prolonged field care might be required. However, rapid confirmation of balloon delivery is a challenge which relies on estimates derived from anatomical measurements or trans-abdominal ultrasound. In addition, confirmation of adequate balloon expansion is difficult. Intravascular ultrasound (IVUS) offers a solution to these two issues, making REBOA a deliverable therapy in the pre-hospital and early hospital settings.MethodsIn an animal model of severe ballistic trauma, following characterisation of the technique, an IVUS-REBOA device was configured, combining a peripheral angioplasty balloon and a digital coronary IVUS catheter. This was introduced via a sheath into the femoral vessel over a conventional angioplasty guide wire.ResultsReal time IVUS imaging allowed confirmation of delivery of the balloon to the aorta, and also demonstrated full apposition once deployed. Furthermore, using ChromaFlo imaging, the device confirmed loss of pulsatile flow in the aorta after deployment, correlating with loss of transduced femoral pressure traces. Post-mortem examination confirmed correct anatomical balloon placement.SummaryFor the first time, in a porcine pilot study, we have demonstrated that IVUS-REBOA is feasible and confirms both correct balloon placement and haemostasis. It has potential to offer advantages to REBOA operators especially during the pre-hospital and retrieval phases, and in the early phase of hospital delivered damage control resuscitation at remote locations.

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