New toys in trauma management

Tourniquet (Leone)

Always apply 5-10cm above the wound but never over a joint

Do not exceed 2 hours of use

References

European guidelines for management of bleeding in trauma

Choice of tourniquet

Practical use of tourniquets

Tourniquet use in civilian population

Transcranial Doppler (Duranteau)

Detects poor flow in TBI but also carotid dissection

Transcranial doppler should be art of multimodality monitoring in TBI

References

Is there a role for transcranial doppler in TBI

TCD US guided therapy in TBI

 

REBOA (Thomas)

Resuscitative endovascular balloon occlusion to the aorta

How to insert – Seldinger technique, aiming to place infra-renal

What happens – aorta occluded, bleeding then stopped surgically or radiologically

What can go wrong – Ischaemic limbs, misplacement, dissection

Before REBOA, make sure you have done all the basics!

Useful resource – http://lifeinthefastlane.com/ccc/resuscitative-endovascular-balloon-occlusion-aorta-reboa/

References

REBOA in Japan

The role of REBOA in torso haemorrhage