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/

Avsnitt(1145)

Podcast 678: ECMO for Refractory VFib

Podcast 678: ECMO for Refractory VFib

Contributor: Aaron Lessen, MD Educational Pearls: Refractory ventricular fibrillation, defined as 3 defibrillation shocks without resolution, was studied via RCT looking to compare ECMO with cardiac...

8 Juni 20213min

Podcast 677: Oatmeal Cream for Hand Eczema

Podcast 677: Oatmeal Cream for Hand Eczema

Contributor: Jared Scott, MD Educational Pearls: Hand eczema is present in about 10% of the population and has a great prevalence in hairdressers, healthcare workers, and food service employees Usin...

7 Juni 20214min

Podcast 676: Spontaneous Bacterial Peritonitis

Podcast 676: Spontaneous Bacterial Peritonitis

Contributor:  Sam Killian, MD Educational Pearls: Patients with cirrhosis and ascites are frequently evaluated for spontaneous bacterial peritonitis, an infection of the ascites fluid that is not fro...

31 Maj 20214min

Pharmacy Phriday #10: Colorado Pharmacists Association 2020 Opioid Prescribing and Treatment Guidelines

Pharmacy Phriday #10: Colorado Pharmacists Association 2020 Opioid Prescribing and Treatment Guidelines

This week's Pharmacy Phriday features a short excerpt from a longer podcast released as promo for the Colorado's CURE initiative, Clinicians United to Resolve the Epidemic, that combats the opioid cri...

28 Maj 202121min

Podcast 675: CHF like it's 1966

Podcast 675: CHF like it's 1966

Contributor: Chris Holmes, MD Educational Pearls: Medicine is cyclical and practice is always evolving A description of recommended treatment for CHF from 1966 Give oxygen Give one dose morphine t...

26 Maj 20216min

Podcast 674: Facial Nerve Palsy in Kids

Podcast 674: Facial Nerve Palsy in Kids

Contributor: Aaron Lessen, MD Educational Pearls: Facial nerve palsy (Bell's palsy) can occur in pediatric patients with Lyme disease, viral infection, or even leukemia One trial sought out to find ...

25 Maj 20214min

Podcast 673: Leaving the ED with Naloxone

Podcast 673: Leaving the ED with Naloxone

Contributor: Don Stader, MD Educational Pearls: Patients are more likely to survive an opioid overdose if they have naloxone 10% risk of death in the year following an opioid overdose of patients see...

24 Maj 20216min

Podcast 672: Oxygen Things

Podcast 672: Oxygen Things

Contributor: Aaron Lessen , MD Educational Pearls: Patients on 10L or more of oxygen per minute in the ICU were randomized to oxygen goals of 90% or 96% to compare 90-day mortality rates Mortality ra...

18 Maj 20212min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion
rss-vetenskapsradion-2
sexet
halsorevolutionen
rss-ufo-bortom-rimligt-tvivel
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
rss-spraket
medicinvetarna
bildningspodden
vetenskapsradion
rss-lara-fran-larda-en-fackbok-och-en-forfattare