Page 244 - 2023 SMOG Digital

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 report from team that placed device.
o Who inserted the device?
o What type of device (ER-REBOA)?
o Where located (Zone 1 or Zone 3)? How confirmed? (xray, ultrasound)
o When was the balloon inflated?
o Why was it placed (Arrest? Peri-arrest? Pelvic bleed?)
o How is the device secured?

• Confirm vital sign trends with sending team
• Confirm security of REBOA device with sutures, commercial securing device, or
tape.
• Record the length measurement at insertion site.
• Confirm balloon pressure.
• Check distal circulation and any external hemorrhage (Doppler)
• Connect Arterial line to hemodynamic monitoring device.
• Verbalize plan to move patient to next level of care. Ensure time of balloon inflation.
• Continue to closely monitor until 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
• Dislodge of device
• Loss of distal circulation
• Distal external hemorrhage

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