A course on endovascular training for resuscitative endovascular balloon occlusion of the aorta: a pilot study for residents and specialists

Purpose Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a salvage technique changing the paradigm in the management of noncompressible torso hemorrhage. However, training for the REBOA procedure is rarely performed. The endovascular training for REBOA (ET-REBOA) course was conducted to develop the endovascular skills of participants. Methods Sixteen residents and 12 specialists participated in this educational course. All participants were provided with precourse learning materials. The ET-REBOA course consisted of 2 sections; an ultrasound-guided sheath insertion on the puncture model, and a balloon manipulation on the vascular circuit model. A 13-item procedure checklist and the time required to perform the procedure were examined. Pre/post self-reported confidence score and course satisfaction questionnaire were obtained. Results Twenty-eight participants performed the 56 REBOA procedures. On the first attempt, the median total time for REBOA from ultrasound-guided vascular access to balloon inflation was 1,139 ± 250 seconds in the resident group and 828 ± 280 seconds in the specialist group. The median shortened time for completion was 273 seconds and 290 seconds respectively. A significant decrease in procedure task time was observed between first and second attempts in the resident group (P = 0.016), specialist group (P = 0.004), and in total among all participants (P < 0.001). Conclusion The ET-REBOA course significantly decreased the time taken to perform the REBOA procedure with high satisfaction of the participants. The course could be an effective curriculum for the development of endovascular skills for performing REBOA.

[1]  D. King,et al.  Initial Care of the Severely Injured Patient. , 2019, The New England journal of medicine.

[2]  Dong Hun Kim,et al.  The utilization of resuscitative endovascular balloon occlusion of the aorta: preparation, technique, and the implementation of a novel approach to stabilizing hemorrhage. , 2018, Journal of thoracic disease.

[3]  K. Elias,et al.  „Resuscitative endovascular balloon occlusion of the aorta“ , 2018, Der Unfallchirurg.

[4]  M. Barozzi,et al.  Resuscitative Endovascular Balloon Occlusion of the Aorta in trauma: a systematic review of the literature , 2017, World Journal of Emergency Surgery.

[5]  L. Handolin,et al.  The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry , 2017, European Journal of Trauma and Emergency Surgery.

[6]  Hyoseon Choi,et al.  Flipped-learning course design and evaluation through student self-assessment in a predental science class , 2017, Korean journal of medical education.

[7]  P. Giannoudis,et al.  Resuscitative endovascular balloon occlusion of the aorta (REBOA): What have we learned? , 2016, Injury.

[8]  Jeremy W. Cannon,et al.  A systematic review of the use of resuscitative endovascular balloon occlusion of the aorta in the management of hemorrhagic shock , 2016, The journal of trauma and acute care surgery.

[9]  L. Cancio,et al.  Resuscitative endovascular balloon occlusion of the aorta for hemorrhage control: Past, present, and future , 2015, The journal of trauma and acute care surgery.

[10]  T. Scalea,et al.  Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for noncompressible truncal hemorrhage , 2015, The journal of trauma and acute care surgery.

[11]  K. Jung,et al.  Risk factors for mortality of severe trauma based on 3 years' data at a single Korean institution , 2015, Annals of surgical treatment and research.

[12]  P. Rhee,et al.  An evidence-based approach to patient selection for emergency department thoracotomy: A practice management guideline from the Eastern Association for the Surgery of Trauma , 2015, The journal of trauma and acute care surgery.

[13]  H. Yokota,et al.  Evaluation of the safety and feasibility of resuscitative endovascular balloon occlusion of the aorta , 2015, The journal of trauma and acute care surgery.

[14]  T. Scalea,et al.  Basic endovascular skills for trauma course: Bridging the gap between endovascular techniques and the acute care surgeon , 2014, The journal of trauma and acute care surgery.

[15]  R. Stansfield,et al.  Endovascular Skills for Trauma and Resuscitative Surgery (ESTARS) course: Curriculum development, content validation, and program assessment , 2014, The journal of trauma and acute care surgery.