London’s Air Ambulance (LAA), the charity that delivers a 24/7 advanced trauma team to critically injured people in London, has performed what it believes was the world’s first roadside balloon surgery to control internal bleeding. The organisation described its use of pre-hospital resuscitative endovascular balloon occlusion of the aorta (REBOA to control haemorrhage in trauma patients as a ‘ground breaking’ move. The charity can now perform REBOA on patients suffering severe pelvic haemorrhage, an injury most commonly associated with cycling incidents and falls from height.
Commenting on the use of REBOA to treat trauma patients, Dr Gareth Davies (pictured), medical director for London’s Air Ambulance, said: “Our aim is to provide our patients with the world’s most innovative and effective pre-hospital care. Being able to effectively manage blood loss at the scene is a significant advancement in pre-hospital medicine. 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 where there are highly developed systems for stabilising and preventing blood loss.”
REBOA works by controlling or preventing further blood loss. The balloon is fed into the bottom end of the aorta, the largest blood vessel in the body, and then inflated, temporarily cutting off blood supply to damaged blood vessels. The patient is then transported rapidly to the Royal London Hospital to undergo further vital interventions.
London’s Air Ambulance has worked closely with the Royal London Hospital to deliver REBOA safely in A&E before embarking on the surgery outside of hospital.
Speaking about this partnership, Professor Karim Brohi, consultant vascular and trauma surgeon at Barts Health NHS Trust said: “We have to stop people bleeding to death – it’s one of the world's biggest killers. Over 2.5 million people bleed to death from their injuries each year around the world. The Royal London Hospital major trauma centre and London’s Air Ambulance have together led the way in developing new strategies and treatments to reduce this death toll. While it sounds relatively simple, it is an extremely difficult technology to deliver in the emergency department in hospital, never mind at the roadside. This successful deployment of REBOA represents nearly two years of development work by our staff. We are excited about the potential for REBOA to reduce death and suffering after trauma and will continue to evaluate and develop the technology into the future.”
Mayor of London Boris Johnson said: “It’s astonishing to see how these stunning advances in medical care are helping people survive serious injury in London … That change is being pioneered and delivered by an incredible group of men and women – the doctors, paramedics, pilots and support staff of the London Air Ambulance.”