Proactive Use of Whole-Body Computed Tomography and Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamically Unstable Trauma Patients

Abstract

It is well known that whole body computed tomography (WBCT) scans in hemodynamically unstable trauma patients (HUPs) should not be performed due to time concerns. Recently, with the shortening of CT scan time accomplished by quick preparation and scanning, WBCT in the patient population utilizing resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma cases could lead to better subsequent management, especially for patients with unknown bleeding points without known mechanism of injury, possible traumatic brain injury, and geriatric trauma with coagulopathy. During a CT scan with contrast, the REBOA balloon is not necessarily deflated further. The training of the CT scan team could shorten the CT room stay time to under 5 min. The images should be read quickly following focused assessment of the scans for trauma by trauma radiologists. REBOA WBCT scans in HUPs with appropriate protocols and image readings might be the tool for choosing a better management in order to restrain hemorrhage.