70: REBOA REDUX – Management of Hemorrhagic Shock in Non-Trauma Patients – with Bellezzo & Zaf Qasim

What this episode covers

January 1, 2021: The year following COVID19 Global Pandemic brings us a new horizon - lets appreciate what has happened, learn from our mistakes and begin to look forward. In this episode Joe Bellezzo talks with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) expert Dr. Zaf Qasim about NON-TRAUMA applications of aortic compression for control of non-compressible non-trauma torso hemorrhage. Dr. Qasim is a world expert in REBOA and has been on the podcast: edecmo.org/35 - REBOA revisited edecmo.org/49 - the ACEP-ACS joint statement controversy edecmo.org/59 - Partial REBOA REBOA in Hemorrhagic Shock from NON-Trauma Mechanisms: This episode is highlighted by a remarkable case, managed by Emergency Physician Dr. Garrett Sterling, of a 77 year old patient who suffered non-traumatic hemorrhagic shock from an Iliac artery pseudo-aneurysm that had fistulized to the urinary tract. The patient was bleeding to death from a fistula between the common iliac artery and the ureter. You have to listen to Dr. Sterling describe this case. The patient was resuscitated with REBOA and her pathology was fixed by an Iliac Artery stent placed in Interventional Radiology. We discuss this case which highlights the benefit of REBOA as a bridge to definitive hemorrhage control. Amazing patient who had an Iliac pseudo-aneurysm causing hemorrhagic shock through the urinary tract, resuscitated using REBOA. Joe and Zaf talk about: * brief history of managing hemorrhagic shock with aortic occlusion * 'Knee REBOA' * Resuscitative thoracotomy * REBOA in trauma * REBOA in non-trauma hemorrhagic shock REFERENCES: https://pubmed.ncbi.nlm.nih.gov/29922894/ https://pubmed.ncbi.nlm.nih.gov/31799415/ https://pubmed.ncbi.nlm.nih.gov/32707397/ https://pubmed.ncbi.nlm.nih.gov/31668242/ https://tsaco.bmj.com/content/4/1/e000376 https://pubmed.ncbi.nlm.nih.gov/29421694/ https://www.jsomonline.org/FeatureArticle/20202110O'Dochartaigh.pdf

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