Purpose

This CPG reviews the range of accepted management approaches for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a hemorrhage control adjunct in traumatic shock and post-traumatic cardiac arrest in combat casualties. Updated guidelines exist for the use of REBOA in the civilian clinical setting. The use of REBOA in the military setting is less well defined. Prior CPGs relied heavily on expert opinion and consensus from military thought leaders. Civilian guidelines currently apply to well-resourced civilian centers with expertise in trauma care. Recommendations for use in the military setting must consider the unique challenges of the deployed environment. Mission parameters, tactical situation, casualty’s physical location and evacuation capability also determine the capabilities available for combat casualty care. Mechanisms and patterns of injury, and the availability and experience level of surgical resources and resuscitation teams all influence the care rendered on the field. The optimal management is best determined by the clinician at the bedside. This document does not address the use of REBOA for indications other than trauma and traumatic hemorrhage.