https://padlet.com/alark/qim0v9dsn1i8 A quick guide on resuscitative endovascular balloon occlusion of the aorta en-us 2018-09-26 22:12:07 UTC 2018-10-05 16:19:34 UTC hello@padlet.com https://padlet-assets.s3.amazonaws.com/icons/Removelove.png alark https://padlet.com/alark/qim0v9dsn1i8/wish/286282647
Conceived by trauma surgeons Dr. Todd Rasmussen, MD, FACS, Colonel, USAF MC and Dr. Jonathan Eliason, MD, produced by Prytime Medical - The REBOA company^TM.
FDA approved for pre marketing in October 2015
Case Report from the Journal of Endovascular Resuscitation and Trauma Management]]> 2018-09-26 22:18:45 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286282647 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286285651 The REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is technically a technique utilized in a traumatic setting when blood loss will likely lead to traumatic arrest and essentially cuts off blood flow from distally from the point of occlusion. The ER - REBOA is a device developed by trauma surgeons who served in the multiple wars and oft saw senseless loss of life from hemorrhagic shock. Applying tourniquets to stop a bleed was easy enough to an extremity, how is one to tourniquet an internal injury like a sheared pelvis? 
The answer is through a traditional femoral arterial line, at least 7Fr in size, where a balloon disguised in a normal sheath can be inserted and travelled by hand to the aorta, and positioned according to length. The balloon is then inflated, occluding distally and thus preventing further blood loss below the line of inflation. The key is early identification and early implementation of the ER - REBOA.]]> 2018-09-26 22:39:56 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286285651 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286289674 This is how! (Please note that the video does not substitute as a training session and providers must still receive formal training on how to use the ER-REBOA prior to performing this procedure on real people.)]]> 2018-09-26 23:12:13 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286289674 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286290762 Traumatic Arrest Algorithm with regards to REBOA]]> 2018-09-26 23:22:12 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286290762 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286291313

Inserting an ER - REBOA is a quick and easy solution to stop internal hemorrhaging from the chest downward

Less invasive than a resuscitative thoracotomy

It does not require imaging for placement so REBOA can be performed in even a resource-limited setting

It does not require imaging for verification of placement, simply look at improvement in you patient's vital signs and arterial wave form for to establish position in an emergent case

The material are radiopaque, therefore do not interfere with the reading of images

It is compliant with many already-stocked arterial access setups, including the common Cordis

Has built-in arterial blood pressure monitoring above the balloon, therefore balloon inflation will not affect arterial line readings

]]> 2018-09-26 23:26:28 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286291313 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286292317

Providers need to be trained in how to place the ER-REBOA, and currently only 150 Level 1 Trauma Centers utilize it

Occluding the distal aorta can lead to extremity ischemia in less than 30 minutes

Femoral vascular access is required, aorta cannot be accessed with minimal invasion any other way

The American College of Surgeons (ACS) and American College of Emergency Physicians (ACEP) recommend that an acute care surgeon be immediately available upon placement of ER-REBOA.

Little research has been done on short- and long-term effects due to small patient population that qualify for REBOA

]]> 2018-09-26 23:34:32 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286292317 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286294783 As someone who works in the Trauma Department of a major metroplex in the United States, I am spoiled with our Level 1 Trauma Facility. We have world-class Emergency Medicine Physicians and Trauma Surgeons in the ER and on-call 24/7. I stand behind the ER-REBOA fully because I have seen it in action and it is incredible: I have seen a patient with a plummeting blood pressure, increasing tachycardia, shredded pelvis become swollen with blood loss, near-amputated lower extremities filling box splints with pools of blood, approximately 40 units of blood products administered in a short time frame. I saw the implementation of the ER-REBOA by my attending trauma surgeon, and then I saw that patient clinically turn around 180 degrees. The patient was hemodynamically stabilized and immediately transferred to Interventional Radiology for pelvic vessel stabilization. That patient is alive today because of REBOA, and she never lets our trauma team forget it.]]> 2018-09-26 23:48:45 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286294783 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286296026 My top five strengths are adaptability, restorative, input, ideation, and learner.
My teammates going forward with this innovation would be:
Fernando - My team will need someone who will prioritize how we will stay on track and then act on it. Every team needs a dependable, focused person who can follow-through. 
Daisy - as a developer, Daisy can hone in on every individual's strengths and utilize it to benefit the team.
Randall - Randall will establish responsibility amongst the team and for himself. He will be a vital part in keeping the team honest and loyal to the project.
Sheila - Sheila will be key in that she thinks strategically. She has an eye for potential problems and she will work well with Fernando to iron out any kinks.
William - I would love to utilize William's "Woo" in winning over anyone who has hesitation about our innovative idea but may not voice it where we could discuss it. He could break the ice with any hold-outs and we could lay out information to ensure an informed decision.]]> 2018-09-26 23:57:03 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286296026 alark https://padlet.com/alark/qim0v9dsn1i8/wish/286300397 Brenner, M., Bulger, E. M., Perina, D. G., Henry, S., Kang, C. S., Rotondo, M. F., . . . Stewart, R. M. (2017). Joint statement from the American College of Surgeons Committee on Trauma (ACS COT) and the American College of Emergency Physicians (ACEP) regarding the clinical use of Resuscitative Endovascular Balloon Occlusion of the Aorta. British Medical Journal, 3(1), 1-3. doi:10.1136/tsaco-2017-000154

Cornelius, B., Campbell, R., & McGauley, P. (2017). Tourniquets in Trauma Care: A Review of Application [Abstract]. Journal of Trauma Nursing, 24(3), 203-207. doi:10.1097/JTN000000000000290

FDA. (n.d.). 510(k) Premarket Notification. Retrieved September 26, 2018, from https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K151821]]> 2018-09-27 00:25:38 UTC https://padlet.com/alark/qim0v9dsn1i8/wish/286300397