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Balloon surgery stops fatal bleeding at roadside | Balloon surgery stops fatal bleeding at roadside |
(about 4 hours later) | |
London's Air Ambulance crew have become the first team in the world to use a balloon device to control catastrophic bleeding at the roadside. | London's Air Ambulance crew have become the first team in the world to use a balloon device to control catastrophic bleeding at the roadside. |
They hope technique will also help prevent deaths and disability from road collisions and falls from height. | They hope technique will also help prevent deaths and disability from road collisions and falls from height. |
The small balloon is inflated inside major blood vessels to stop internal blood loss - a common cause of death after severe injuries. | The small balloon is inflated inside major blood vessels to stop internal blood loss - a common cause of death after severe injuries. |
This may be a "major advance" in trauma care outside hospitals, experts say. | This may be a "major advance" in trauma care outside hospitals, experts say. |
The technique, known as Reboa (resuscitative endovascular balloon occlusion of the aorta), was first used in the UK by the Royal London Hospital. | The technique, known as Reboa (resuscitative endovascular balloon occlusion of the aorta), was first used in the UK by the Royal London Hospital. |
And after two years of further development, London's Air Ambulance paramedics have used it to treat a patient who suffered severe pelvic injuries and bleeding. | And after two years of further development, London's Air Ambulance paramedics have used it to treat a patient who suffered severe pelvic injuries and bleeding. |
'Inflated balloon' | 'Inflated balloon' |
Pedestrians or cyclists involved in serious crashes often have internal bleeding due to injury to blood vessels deep inside the body - these cannot be compressed from the outside. | Pedestrians or cyclists involved in serious crashes often have internal bleeding due to injury to blood vessels deep inside the body - these cannot be compressed from the outside. |
But this technique allows doctors to gain access quickly and control bleeding from within. | But this technique allows doctors to gain access quickly and control bleeding from within. |
When the pelvis is injured - for example - large vessels in that area can be torn, leading to massive blood loss. | When the pelvis is injured - for example - large vessels in that area can be torn, leading to massive blood loss. |
And some people will die at the scene or before they can be transferred safely to hospital. | And some people will die at the scene or before they can be transferred safely to hospital. |
Dr Gareth Davies, medical director at London's Air Ambulance and emergency medicine consultant at Barts Health NHS Trust, said: "We believe the use of Reboa can lead to a reduction in the number of patients who quite simply bleed to death before they have the chance to get to hospital." | |
How the device is used: | How the device is used: |
The device is made of a thin plastic tube with a balloon at the tip. | The device is made of a thin plastic tube with a balloon at the tip. |
Using a series of guide wires, the tube is fed, through a vessel in the leg, into the lower part of the aorta - the major blood vessel in the body. | Using a series of guide wires, the tube is fed, through a vessel in the leg, into the lower part of the aorta - the major blood vessel in the body. |
And once in the correct position it can then be inflated using a small amount of liquid, temporarily cutting off blood supply to the damaged blood vessels. | And once in the correct position it can then be inflated using a small amount of liquid, temporarily cutting off blood supply to the damaged blood vessels. |
Buying time | Buying time |
This can buy doctors and paramedics valuable time to get the patient to the nearest hospital where further surgery may be carried out. | This can buy doctors and paramedics valuable time to get the patient to the nearest hospital where further surgery may be carried out. |
Mr David Nott, a surgeon at St Mary's Hospital, London, who was not involved in this work, said: "This is a fantastic idea. | Mr David Nott, a surgeon at St Mary's Hospital, London, who was not involved in this work, said: "This is a fantastic idea. |
"Stopping the bleeding as soon as possible has to be the way forward, and this balloon may help stop it almost immediately. | "Stopping the bleeding as soon as possible has to be the way forward, and this balloon may help stop it almost immediately. |
"Obviously this is new for pre-hospital care - it will have to be used by people experienced and trained in trauma care. | "Obviously this is new for pre-hospital care - it will have to be used by people experienced and trained in trauma care. |
"It could be a major advance in the treatment of trauma." | "It could be a major advance in the treatment of trauma." |
Prof Karim Brohi, at Barts Health NHS Trust ,who was involved in developing the roadside technique, said: "Over 2.5 million people bleed to death from their injuries each year around the world. | Prof Karim Brohi, at Barts Health NHS Trust ,who was involved in developing the roadside technique, said: "Over 2.5 million people bleed to death from their injuries each year around the world. |
"We have to stop people bleeding to death - it's one of the world's biggest killers. | "We have to stop people bleeding to death - it's one of the world's biggest killers. |
"And while Reboa sounds relatively simple, it is an extremely difficult technology to deliver in an emergency department in hospital, never mind at the roadside." | "And while Reboa sounds relatively simple, it is an extremely difficult technology to deliver in an emergency department in hospital, never mind at the roadside." |