REBOA: The Internal Tourniquet

By: Guest Author | Posted on: Jun 21, 2017

 This article was originally published on nytimes.com by . View the original article by clicking here. 

 REBOA, Cascade Training Center, Cascade Training, Cascade Healthcare ServicesA high school senior mowed down by a car with other pedestrians in last month’s Times Square attack was hemorrhaging internally and transfusions could not keep up with the blood loss.

Doctors and nurses at NYC Health & Hospitals/Bellevue raced to save the student, Jessica Williams of Dunellen, N.J., who suffered severe injuries to her legs, abdomen and pelvis. But her pulse skyrocketed to 150. Her blood pressure dropped to 40/30.

“She was about to go into cardiac arrest,” said Dr. Marko Bukur, a trauma surgeon.

He grabbed a device that neither he nor anyone else at the hospital had ever used, except in training sessions on mannequins. It had arrived at Bellevue just days before.

The device, called an ER-Reboa catheter, was born on the battlefields of Iraq and Afghanistan, the brainchild of two military doctors who saw soldiers die from internal bleeding that medical teams in small field hospitals could not stop.

Their invention, made by Prytime Medical and cleared by the Food and Drug Administration in 2015, is gradually being adopted in civilian trauma centers around the country and has recently been used by the military. But medical teams need rigorous training to use it: Mishandled, it can be dangerous.

Dr. Bukur punctured Ms. Williams’s thigh, threaded a slim tube into her femoral artery and eased it up about 12 inches into her aorta, the major artery that carries blood from the heart to most of the body. Then he injected salt water to inflate a balloon near the tip of the tube, blocking the aorta and cutting off circulation to Ms. Williams’s pelvis and legs. Above the balloon, blood still flowed normally to her brain, heart, lungs and other vital organs.


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