Podcast #258: REBOA
Emergency Medical Minute6 Okt 2017

Podcast #258: REBOA

Author: Dylan Luyten, M.D.

Educational Pearls

  • Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).
  • Exsanguination is a major cause of mortality in trauma
  • One temporizing technique to buy time to definitive hemorrhage control is to occlude the aorta thereby shunting blood away from pelvis and lower extremities, increasing cardiac afterload to increase myocardial and brain perfusion.
  • Rather than perform a thoracotomy to cross clamp aorta, a REBOA catheter may be introduced into the aorta via the common femoral artery and a balloon inflated in the descending aorta to occlude it.
  • The indications for REBOA include PEA arrest of brief duration attributable to exsanguination for sub-diaphragmatic source in a young, healthy patient, or severe hypovolemic shock or those in an agonal state due to non-compressible hemorrhage not responding to volume and in whom obstructive cause of shock has been ruled out.
  • Contraindicated in prolonged arrest, suspected proximal aortic injury, advanced age/comorbidities.
  • Controversies and evidence:

    • High quality evidence is lacking - as it is for much of what we do and even consider standard of care in trauma. It has not been shown to improve survival, which is hard to demonstrate.

    • Role in remote settings vs trauma centers unclear.

    • Further refinements of indication for use are likely to occur with time and experience.

  • Summarize - REBOA is a promising relatively new technology that may have potential to improve outcomes in the sickest of trauma patients.

Reference: https://lifeinthefastlane.com/ccc/resuscitative-endovascular-balloon-occlusion-aorta-reboa/

Episoder(1145)

Podcast 795: Lithium Toxicity

Podcast 795: Lithium Toxicity

Contributor: Peter Bakes, MD Educational Pearls: Lithium remains a commonly used medication for treating bipolar disorder Lithium toxicity can be acute, acute-on-chronic, or chronic Measuring blood ...

5 Jul 20224min

Podcast 793: Postintubation Sedation and Analgesia

Podcast 793: Postintubation Sedation and Analgesia

Contributor: Peter Bakes, MD Educational Pearls: When intubating a patient, it is important to consider what medications will be used for post-intubation sedation and analgesia The common non-benzodi...

27 Jun 20226min

Podcast 792: Rectal Prolapse

Podcast 792: Rectal Prolapse

Contributor: Jarod Scott, MD Educational Pearls: Rectal prolapse is an evagination of the rectal tissue through the anal opening Factors that weaken the pelvic floor muscles increase the risk of rect...

21 Jun 20224min

Podcast 791: Hyperglycemic Hyperosmolar State

Podcast 791: Hyperglycemic Hyperosmolar State

Contributor: Aaron Lessen, MD Educational Pearls: Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater...

20 Jun 20223min

On the Streets #14: Trauma Activations in the Field

On the Streets #14: Trauma Activations in the Field

The Emergency Medical Minute is excited to announce that we our upcoming event, Palliative. Check out our event page for more information and to buy tickets: Palliative Eventbrite Page

15 Jun 202218min

Podcast 790: Opioids vs OTC Pain Meds

Podcast 790: Opioids vs OTC Pain Meds

Contributor: Aaron Lessen, MD Educational Pearls: NSAIDs are a potential alternative to opioids for pain management and are associated with decreased rates of adverse effects A recent study evaluated...

14 Jun 20223min

Podcast 789: DOAC

Podcast 789: DOAC

Contributor: Aaron Lessen, MD Educational Pearls: Direct Oral Anticoagulants (DOACs) have surpassed Warfarin and Lovenox® for anticoagulation as they do not require injection and allow for easier di...

13 Jun 20223min

Mental Health Monthly #13: Substance-Induced Psychosis (Part I)

Mental Health Monthly #13: Substance-Induced Psychosis (Part I)

Substance-Induced Psychosis (Part I) In this first episode of a two-part mini-series, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, a...

8 Jun 202216min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
vett-og-vitenskap-med-gaute-einevoll
rss-nysgjerrige-norge
rss-rekommandert
sinnsyn
smart-forklart
nordnorsk-historie
villmarksliv
rss-paradigmepodden
forskningno
pod-britannia
fjellsportpodden
aldring-og-helse-podden
diagnose
rss-overskuddsliv
tomprat-med-gunnar-tjomlid
tidlose-historier