This week Paul Rees returns to discuss the trans specialty procedure of REBOA. He looks at why it isn’t commonly used in PHEM but talks about the situations where it could usefully be incorporated into the pre hospital emergency environment.
Key points from this podcast:
- Adopt a whole system approach and deliver the patient to a centre who can help to stabilise them
- Access, access, access, start training now with Ultrasound. Know how to subtly manage the probe to get vascular access with ultrasound.
- If in a system employing the REBOA system consider the inflation time carefully
Resources related to this podcast:
Norwegian HEMS REBOA paper (open access) – https://www.ahajournals.org/doi/epub/10.1161/JAHA.119.014394
Paul Rees is a military interventional cardioloist at Barts Heart Centre in London, with a special interest in circulatory support and resuscitation. He is also a HEMS consultant, flying for East Anglian Air Ambulance.
As a Surgeon Commander in the Royal Navy, he is their Consultant Advisor in Medicine, as well as Reader in the Academic Department of Military Medicine. He chairs the Defence Resuscitation Committee, leads the Defence Endovascular Resuscitation Group and has recently designed and delivered a new capability for treating battlefield haemorrhage.
He co-leads the new British Cardiovascular Intervention Society group looking at out of hospital cardiac arrest, and teaches as invited faculty on a number of international endovascular resuscitation workshops. Paul’s military background includes active service with submarines, combat deployment with Commando forces, being the airborne MERT consultant in Afghanistan and numerous humanitarian and disaster relief missions including work in an Ebola treatment unit in Africa.