Trauma Pan-Scan in Resuscitative Endovascular Occlusion: A Novel Strategy for Hemodynamically Unstable Polytrauma Patients

Abstract

The trauma pan-scan (TPS) offers particular benefits in trauma care. Resuscitative endovascular balloon occlusion of the aorta (REBOA) may provide an opportunity to scan hemodynamically unstable (HU) polytrauma patients; however, the benefits and risks of REBOA-TPS remain unknown. The rationale for TPS in HU patients is to choose the best intervention and to quickly achieve hemostasis rather than directly initiating surgery without scanning. TPS would most greatly benefit geriatric trauma patients and those with coagulopathies with unidentified bleeding sources, particularly noncavitary hemorrhage in blunt trauma and accompanying brain injury, because TPS may predict unexpected physiological collapse via anatomical imaging. Computed tomography (CT) is a common cause of flow disruption, but specific trauma team training was shown to reduce the time spent in the CT room from 16.8 to 7.3 minutes (P < 0.001). While REBOA-TPS cannot be utilized widely or indiscriminately, its appropriate use may increase the number of salvageable trauma patients.