Precision Trauma

Simple and effective. Great bleeding control training with a local school today. Learn and equip yourself to save a life.

Repost from . You have heard of REBOA, well how about GROA? Gastroesophageal Resuscitative Occlusion of
the Aorta. Concept- Place a balloon in the stomach (think OG tube), inflate and apply external
pressure to the abdomen= High zone 2 Aortic Occlusion. Let’s see how it works.
Background: Non-Compressible Torso Hemorrhage (NCTH) is a major source of death and a
significant challenge in prehospital care. Aortic cross clamping via thoracotomy remains the in
hospital gold standard and has been rarely performed out of the hospital successfully, as this
requires a surgical team and significant skills. REBOA has become very popular in recent years
as a way to attempt to treat NCTH. REBOA poses a significant challenge in that femoral artery
vascular access and balloon management can prove very difficult in the hemorrhagic shock
patient in the prehospital setting. GROA was invented as a way to perform aortic occlusion in
an austere environment with a simple procedure. Study(feasibility): 35% hemorrhage induced, REBOA group had balloon inflation, GROA group
had balloon inflation and external pressure applied, both groups confirmed loss of femoral
artery waveform. Resuscitation was then performed with autologous whole blood, LR and
Calcium chloride. At the end of intervention for each group, devices were slowly released and
MAP of >60 was maintained.
Results: Survival- Groups- GROA/REBOA at 30, 60 and 90 minutes. Survival for corresponding
groups was (30 min) 4 of 5 and 5 of 5, (60min) 5 of 5 and 4 of 5, (90min) 2 of 6 and 0 of 6.
Similar survival results with GROA and REBOA. 2 animals survived beyond 90 minutes in the
GROA group (tolerance likely 60 min for both groups). MAP and SVO2 increased in both groups
suggesting redistribution to heart, lungs and brain. PAP increased but stayed below 40 in the
GROA group. The authors suggest that this may be a much faster way of achieving aortic
occlusion in the field as a bridge to definitive surgical hemostasis (or REBOA).
Reference: Journal of Trauma: Gastroesophageal resuscitative occlusion of the aorta: Physiologic
tolerance in a swine model of hemorrhagic shock

Proud to sponsor local high school sports. Go !

9/11 is a day that affected every one of us at Precision Trauma in a deep and life changing way. For the rest of our careers, and each day after we will never be the same. We stand with those who paid the ultimate sacrifice and those who spend their lives protecting, defending, and rescuing this nation. United We Stand.
---------
Tribute in lights illuminate downtown in New York, NY on Sunday, Sept. 11, 2016. Photo by Jin Lee,9/11 Memorial