The AAJT: Simplicity in the Face of Adversity

​There is a saying, "Complexity in the face of adversity breeds chaos." I'm not sure where this maxim originated, but it is definitely true in resuscitation settings. That's the crux of this post: Is the abdominal tourniquet simplicity in the face of adversity compared with the resuscitative endovascular balloon occlusion of the aorta (REBOA)?​We all know how futile it feels to do CPR on a traumatic cardiac arrest patient with suspected massive blood loss. Just what are we pumping, and if there is any remaining intravascular blood, where are we pumping it?I will never forget the pain of trying to resuscitate an 11-year-old boy who was run over by a neighbor turning into her driveway. She never saw him as he rolled down the street lying flat on his skate board. He received everything we had, including an open thoracotomy and aortic cross-clamping. He ultimately died from severe liver lacerations and venous injuries.This patient and thousands like him demonstrate that we need more tools in the fight against this type of traumatic cardiac arrest. Before someone else points it out, we need to be clear that traumatic arrests are not simply the proverbial internal injuries. The Centers for Disease Control and Prevention estimated that 30 percent of all injury-related deaths are due to brain injuries in the United States. (MMWR Surveill Summ 2017;66[9]:1.) Many of those patients will also have noncompressible torso hemorrhage.Open thoracotomy can occasionally b...
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