[Effect of a 1-day "REBOA course" on the theoretical and practical skills for the prehospital REBOA setting : Experiences from the RIBCAP-HEMS project].

Die Anaesthesiologie Pub Date : 2023-12-01 Epub Date: 2023-11-24 DOI:10.1007/s00101-023-01359-0
Peter Hilbert-Carius, Fridolin Streibert, Daniel Ebert, Alexander Vogt, Matthias Beese, Jörn Tongers, Gunther Hofmann, Jörg Braun
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Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) represents an endovascular procedure for aortic occlusion. The procedure can be used for temporary hemorrhage control as a bridge until surgical treatment for noncompressible abdominal or pelvic bleeding and to improve coronary and cerebral perfusion pressure during cardiopulmonary resuscitation. The prehospital administration is challenging and currently hardly possible in Germany. In the REBOA in bleeding and cardiac arrest in the prehospital care by helicopter emergency medical service (RIBCAP-HEMS) project, the prehospital use of REBOA will be tested in a feasibility study. This article describes the training course on the procedure in preparation for prehospital use, which was conducted before the start of the aforementioned feasibility study for the emergency physicians and paramedics (HEMS-TC) of the DRF Air Rescue Base in Halle (Saale). The course provided the necessary theoretical and practical skills to apply REBOA in the prehospital setting to patients in extremis in a safe, indications-conform and time-critical manner. The fact that all emergency physicians of the two air ambulances Christoph 84 and Christoph 85 in Halle are specialists in anesthesiology with corresponding experience in the placement of invasive arterial catheters proved to be advantageous. The training course was able to significantly improve the theoretical and practical abilities of the participants. The results of the currently ongoing study must show whether the procedure can be usefully integrated into the prehospital care of patients in extremis.

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[为期一天的“REBOA课程”对院前REBOA设置的理论和实践技能的影响:来自RIBCAP-HEMS项目的经验]。
复苏血管内球囊阻塞主动脉(REBOA)是主动脉阻塞的血管内手术。该程序可用于暂时出血控制,作为手术治疗不可压缩性腹部或盆腔出血的桥梁,并可在心肺复苏期间改善冠状动脉和脑灌注压。院前管理具有挑战性,目前在德国几乎不可能。在直升机急救医疗服务在院前出血和心脏骤停中的REBOA项目中,将在一项可行性研究中测试REBOA在院前使用的可行性。本文介绍了院前使用准备程序的培训课程,该课程是在上述可行性研究开始之前为哈勒(萨勒)的刚果民主共和国空军空中救援基地的急诊医生和护理人员(HEMS-TC)进行的。该课程提供必要的理论和实践技能,以安全、符合适应症和时间紧迫的方式在院前环境中应用REBOA。Halle的Christoph 84和Christoph 85两架空中救护车的所有急诊医生都是麻醉学专家,具有放置有创动脉导管的相应经验,这一事实证明是有利的。培训课程能够显著提高学员的理论和实践能力。目前正在进行的研究结果必须表明,该程序是否可以有效地整合到危重患者的院前护理中。
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