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between hemorrhagic shock and a difficultly treatable bleed- national cohort study. Scand J Trauma Resusc Emerg Med. 2018;26
ing such as NCTH is critical to advancing trauma resuscita- (1):30. doi:10.1186/s13049-018-0500-7
tion strategies. The development of effective algorithms that 9. Smith S, White J, Wanis KN, Beckett A, McAlister VC, Hilsden R.
integrate early intervention for both NCTH and hemorrhagic The effectiveness of junctional tourniquets: a systematic review
and meta-analysis. J Trauma Acute Care Surg. 2019;86(3):532–
shock is essential for improving survival outcomes. 539. doi:10.1097/TA.0000000000002159
10. Smith TN, Beaven A, Handford C, Sellon E, Parker PJ. Abdominal
Aortic Junctional Tourniquet - Stabilized (AAJTS) can be applied
Conclusion both successfully and rapidly by Combat Medical Technicians
This review sought to provide a clearer understanding of the (CMTs). BMJ Mil Health. 2023;169(6):493–498. doi:10.1136/
potential role of the AAJT in trauma care, particularly in the bmjmilitary-2021-001881
prehospital management of hemorrhagic shock caused by 11. Rall J, Cox JM, Maddry J. The use of the abdominal aortic and
junctional tourniquet during cardiopulmonary resuscitation fol-
NCTH. If effective, the AAJT could serve as a life-saving device lowing traumatic cardiac arrest in swine. Mil Med. 2017;182(9–
during transports from initial resuscitation up until definitive 10):e2001–e2005. doi:10.7205/MILMED-D-16-00409
surgical care, potentially breaking the cycle of trauma-induced 12. Brännström A, Rocksén D, Hartman J, et al. Abdominal aortic and
mortality that continues to claim thousands of lives each year. junctional tourniquet release after 240 minutes is survivable and
associated with small intestine and liver ischemia after porcine
class II hemorrhage. J Trauma Acute Care Surg. 2018;85(4):717–
While the physiological effects of the AAJT have been well- 724. doi:10.1097/TA.0000000000002013
documented in animal models, there is a notable research gap 13. Rall JM, Ross JD, Clemens MS, Cox JM, Buckley TA, Morrison
regarding its clinical application in human patients with hem- JJ. Hemodynamic effects of the abdominal aortic and junctional
orrhagic shock. Coupled with ongoing concerns about the tourniquet in a hemorrhagic swine model. J Surg Res. 2017;212:
practicality of REBOA’s prehospital use, the AAJT is positioned 159–166. doi:10.1016/j.jss.2017.01.020
as a promising but underexplored tool for managing junctional 14. Do WS, Forte DM, Sheldon RR, et al. Minimally invasive preperi-
trauma and NCTH in severely injured patients. Despite the toneal balloon tamponade and abdominal aortic junctional tourni-
quet versus open packing for pelvic fracture-associated hemorrhage:
limited evidence, the AAJT remains a forward-thinking and not all extrinsic compression is equal. J Trauma Acute Care Surg.
viable option for improving trauma resuscitation protocols, 2019;86(4):625–633. doi:10.1097/TA.0000000000002203
particularly in resource-limited settings. Further research and 15. Kheirabadi BS, Terrazas IB, Miranda N, et al. Long-term conse-
clinical validation will be essential to determine its effectiveness quences of abdominal aortic and junctional tourniquet for hem-
and optimal use in prehospital and EMS. orrhage control. J Surg Res. 2018;231:99–108. doi:10.1016/j.jss.
2018.05.017
16. Anonymous A. Abdominal aortic tourniquet? Use in Afghanistan.
Author Contributions J Spec Oper Med. 2013;13(2):1–2. doi:10.55460/HLJC-DMCK
JK, KM, TI, and AH conceived the study concept and designed 17. Jansen JO, Hudson J, Cochran C, et al. Emergency department re-
the study. JK and AH collected data. JK and AH analyzed and suscitative endovascular balloon occlusion of the aorta in trauma
interpreted the data. JK, KM, TI, and AH wrote the manu- patients with exsanguinating hemorrhage: the UK- REBOA ran-
script draft. domized clinical trial. JAMA. 2023;330(19):1862–1871. doi:10.
1001/jama.2023.20850
18. Brede JR, Rehn M. The end of balloons? Our take on the UK-
Disclosures REBOA trial. Scand J Trauma Resusc Emerg Med. 2023;31(1):69.
The authors have nothing to disclose. doi:10.1186/s13049-023-01142-5
19. Lendrum RA, Perkins Z, Marsden M, et al. Prehospital partial re-
Funding suscitative endovascular balloon occlusion of the aorta for exsan-
No funding was received for this work. guinating subdiaphragmatic hemorrhage. JAMA Surg. 2024;159
(9):998–1007. doi:10.1001/jamasurg.2024.2254
20. Balian F, Garner AA, Weatherall A, Lee A. First experience with
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