Page 218 - 2026 SMOG

REBOA MANAGEMENT
Purpose
Surgical Team or SOF Medic placement for trauma arrest or non-compressible hemorrhage in the
pelvis. Secondary to emergency thoracotomy or external junctional tourniquets
Procedure
• Receive a report from the team that placed the device
˚ Who inserted the device?
˚ What type of device (ER-REBOA)?
˚ Where is it located (Zone 1 or Zone 3)? How confirmed? (X-ray, ultrasound)
˚ When was the balloon inflated?
˚ Why was it placed (Arrest? Peri-arrest? Pelvic bleed?)
˚
How is the device secured?
• Confirm vital sign trends with the sending team.
• Confirm the security of the REBOA device with sutures, a commercial securing device, or tape.
• Record the length measurement at the insertion site
• Confirm balloon pressure
• Check distal circulation and any external hemorrhage (Doppler)
• Connect the arterial line to the hemodynamic monitoring device
• Verbalize the plan to move the patient to the next level of care. Ensure the time of balloon
inflation
• Continue to closely monitor until the patient is secured in the next level of care (hemodynamic
monitoring, distal circulation, device security, catheter depth)
Concerns
• Changes in altitude
• Transient drop in blood pressure
• Change in balloon pressure
• Dislodging of the device
• Loss of distal circulation
• Distal external hemorrhage
• Zone 1 REBOA patients will not be transported via rotary wing aircraft with REBOA inflated;
balloon must be deflated prior to transport
• A medical provider trained in the manipulation of the occlusion balloon should accompany the
patient at all times
**Document procedure, results, and vital signs.**
Reference: CPG ID 38 (Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic
Shock)

210 • PROCEDURES