Feasibility Study Vascular Access and REBOA Placement: From Zero to Hero

Area of Science:

• Emergency Medicine
• Surgical Training
• Vascular Surgery

Background:

• Vascular access is critical for resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with severe hemorrhagic shock.
• Training military medical personnel in REBOA placement is essential for battlefield care.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive training program for military medical personnel in achieving vascular access and REBOA placement.
• To assess the impact of training on procedural times for REBOA insertion.

Main Methods:

• A training program was developed for Special Forces (SOF) medics, combat nurses, and military physicians, with military surgeons as the control group.
• The curriculum included basic anatomy and hands-on training in endovascular toolkit preparation, vascular access, and REBOA placement using a task training model.
• Key skills assessed were time to sheath insertion and time from start to REBOA inflation.

Main Results:

• Military surgeons demonstrated the fastest times for sheath insertion (1:39) and REBOA inflation (2:36).
• SOF medics had longer procedure times compared to nurses, physicians, and surgeons.
• Higher levels of medical training correlated with reduced procedure times.

Conclusions:

• A comprehensive theoretical and practical training program can effectively train military medical personnel, including those without prior endovascular experience, in percutaneous femoral access and REBOA placement.
• Training significantly reduces procedural times, enhancing the feasibility of REBOA for military applications.