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29. Additional hemostatic adjuncts, in particular the prehos- paper. He is also on the Medical Advisory Board for Arse-
pital use of ResQFoam, should be studied. ResQFoam use nal Medical, the Founder and a Board Member of Decisio
might be further optimized through better access tech- Health, a consultant to Terumo BCT, and the co-inventor of
niques and shorter periods of use to help mitigate bowel the Junctional Emergency Treatment Tool. Dr King is a funded
injuries from this device. investigator on the ResQFoam project, which has been sup-
30. The AAJT is a much simpler device to use than undertak- ported by the Defense Advanced Research Projects Agency,
ing a REBOA procedure. Development of technology that the Army Medical Research and Materiel Command, and the
would enable prehospital medical providers to reliably National Institute of Health. He is the Principal Investigator
exclude the possibility of NCTH from sites above the aor- for the REVIVE clinical trial, registered at clinicaltrials.gov.
tic bifurcation would enable pelvic and lower extremity Dr Rasmussen is an active duty service member who has con-
junctional hemorrhage to be treated with the AAJT in the tributed to the Aortic Occlusion System (AOS) patent which
prehospital phase of care. is assigned to the United States Air Force. The Air Force has
received payments from the University of Michigan as part of
Acknowledgments a Joint Ownership Agreement pertaining to this patent. After
The authors gratefully acknowledge the research assistance receipt and withholding of a percentage of any such payment,
provided by Mrs. Danielle Davis of the Joint Trauma System. the Air Force has distributed compensation to Dr Rasmussen.
The authors also thank the Department of Defense Trauma He holds no paid consulting or advisory board positions; he
Registry for providing the casualty data discussed in this paper. holds no stock in Prytime Medical; and receives no payment
related to commercialization of the ER-REBOA catheter. Dr
Disclaimers Spinella is the Co-Founder and on the Board of Directors of
The opinions or assertions contained herein are the private Kalocyte Inc.
views of the authors and are not to be construed as official or
as reflecting the views of the Defense Health Agency or the De- Release
partment of Defense. This recommendation is intended to be This document was reviewed by the Director of the Joint
a guideline only and is not a substitute for clinical judgment. Trauma System and by the Public Affairs Office and the Oper-
ational Security Office at the DoD’s Defense Heath Agency. It
Disclosures is approved for unlimited public release.
Dr Holcomb is the Chief Medical Officer for Prytime Med-
ical, which markets the ER-REBOA device discussed in this

1 Dr Butler is a former SEAL platoon commander and currently serves as chairman of the Joint Trauma System’s Committee on Tactical Com bat
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Casualty Care (TCCC); Dr Holcomb is a professor of surgery in the Department of Surgery, Center for Translational Injury Research, McGovern
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Med ical School, University of Texas Health Science Center at Houston; Dr Shackelford is the incoming director of the Joint Trauma System;
4 Dr Barbabella is the command surgeon for Marine Corps Forces in Europe and Africa; Dr Bailey is the current director of the Joint Trauma
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System; Dr Baker is the command surgeon for US Special Operations Command Europe; Dr Cap is the US Army surgeon general’s consultant
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for hematology and oncology and chairman of Coagulation and Blood Research at the US Army Institute of Surgical Research; SGM Conklin
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is the senior enlisted medical advisor for the Joint Special Operations Command; Dr Cunningham is an EMS physician and chairman of the
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JTS Committee on En Route Combat Casualty Care and a member of the CoTCCC; Dr Davis is the director of the DoD’s Combat Casualty
Care Research Program; LTC DeLellis is the deputy command surgeon for the US Army Special Operations Command; Dr Dorlac is medical
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director, Trauma and Acute Care Surgery for the Medical Center of the Rockies, UC Health; Dr DuBose is the director of the USAF C-STARS
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Program at the R. Adams Cowley Shock Trauma Center; Dr Eastridge is the chief of Trauma and Emergency Surgery at University Hospital in
San Antonio, TX; MAJ Fisher is a former 75th Ranger Regimental PA, now a third-year medical student at Texas A+M College of Medicine;
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16 Dr Glaser is a trauma surgeon at the Naval Medical Research Unit San Antonio, and serves as the Navy liaison to the Joint Trauma System;
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17 Dr Gurney is the assistant director of the USAISR Burn Center and a trauma surgeon at the Joint Trauma System; Dr Jenkins is a clinical
professor in the Division of Trauma and Emergency Surgery, University of Texas Health Sciences Center, San Antonio, TX; Dr Johannigman
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is a professor of surgery, University of Cincinnati College of Medicine; Dr King is a trauma surgeon at the Massachusetts General Hospital;
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21 Dr Kotwal is the director of Special Projects for the Joint Trauma System; Dr Littlejohn is the command surgeon for the Naval Special Warfare
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Development Group; Dr Mabry is the command surgeon for the Joint Special Operations Command; Dr Martin is the chief of trauma at
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Madigan Army Medical Center, Joint Base Lewis-McChord; Dr Miles is the command surgeon for the US Army Maneuver Center of Excellence;
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26 Mr Montgomery is the operational medicine liaison for the JTS Committee on TCCC; Dr Northern is a general surgeon with a USAF Special
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Operations Surgical Team; Dr O’Connor is the director of Executive Medicine at George Washington University Medical Center; Dr Rasmus-
sen is the associate dean for Research at the Uniformed Services University; Dr Riesberg is the command surgeon for the Tenth Special Forces
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Group; Dr Spinella is the director of the Pediatric Critical Care Translational Research Program at St. Louis Children’s Hospital and Professor
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of Pediatrics at Washington University School of Medicine; Dr Stockinger is a trauma surgeon at Naval Hospital Jacksonville and a former
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Director of the Joint Trauma System; Dr Strandenes is the senior anesthetist, Department of War Surgery and Emergency Medicine, Norwegian
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Armed Forces Medical Services; RDML Via is the deputy chief for Readiness and Health, Bureau of Medicine and Surgery; Dr Weber is the
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command surgeon for the US Africa Command.
References can be found online at:
https://www.jsomonline.org/References/2018435Butler.php
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