Trauma pan-scan in resuscitative endovascular occlusion:
a novel strategy for hemodynamically unstable polytrauma patients
Keywords:Resuscitative endovascular balloon occlusion of the aorta; REBOA; Trauma pan-scan; computed tomography; Multidisciplinary training; hemorrhagic shock
Trauma pan-scan (TPS) offers a benefit in trauma care. Resuscitative endovascular resuscitative endovascular occlusion of the aorta (REBOA) may allow the opportunity to scan hemodynamically unstable (HU) polytrauma patients; however, the benefits and risks of REBOA-TPS remains unknown. The rationale for TPS in HU patients is to choose the best disposition and to quickly achieve hemostasis rather than directly initiating surgery without scanning. TPS would most benefit geriatric trauma patients and those with coagulopathies with unidentified bleeding sources, particularly non-cavitary hemorrhage in blunt trauma and accompanying brain injury, because TPS may predict unexpected physiological collapse by anatomical imaging. CT is a common cause of flow disruption, but trauma team training shortened the time spent in the CT room from 16.8 to 7.3 minutes (P<0.001). While REBOA-TPS cannot be utilized widely and indiscriminately, its appropriate use may increase the salvageable trauma population.