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Prehospital External Aortic Compression for Temporizing Exsanguinating Sub-Diaphragmatic Hemorrhage – A Promising Technique, but with Challenges: Four Illustrative Cases, Including Two Survivors

Published online by Cambridge University Press:  13 January 2020

Bruce Richard Paix Open the ORCID record for Bruce Richard Paix [Opens in a new window] ,
David John Tingey ,
Grant Copley ,
Matthew Casson ,
Damien Shoolbread ,
Hari Davuluru ,
James Doube ,
Wade Emmerton  and
Ryan Kennedy
Bruce Richard Paix*
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
David John Tingey
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
Grant Copley
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
Matthew Casson
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Damien Shoolbread
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Hari Davuluru
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
James Doube
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Wade Emmerton
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Ryan Kennedy
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
*
Correspondence: Bruce Paix, MBBS, FANZCA, 26 Smith Rd, Echunga, 5153Australia, E-mail: [email protected]
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Abstract

External aortic compression (EAC) has long been used to control exsanguinating post-partum hemorrhage, but it has only recently been described in the prehospital trauma setting. This paper reports four cases where manual EAC was used during transport to manage life-threatening bleeding, twice from stab wounds, once from ruptured ectopic pregnancy, and once from severe lower-limb trauma. It showed that EAC has life-saving potential in the prehospital setting, but that safety and efficacy during transport requires the use of a hands-free compression device, such as an aortic tourniquet.

Keywords

exsanguinating hemorrhageexternal aortic compressionprehospital care
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 1 , February 2020 , pp. 115 - 118
Copyright
© World Association for Disaster and Emergency Medicine 2020

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References

Riley, D, Burgess, R.External abdominal aortic compression: a study of a resuscitation maneuver for postpartum hemorrhage. Anaesth Intensive Care. 1994;22(5):571–575.CrossRefGoogle Scholar
Keogh, J, Tsokos, N.Aortic compression in massive postpartum hemorrhage – an old but lifesaving technique. Aust NZ J Obstet Gynaecol. 1997;37(2):237–238.CrossRefGoogle ScholarPubMed
Soltan, MH, Faragullah, MF, Mosabah, MH, Al-Adawy, AR.External aortic compression device: the first aid for postpartum hemorrhage control. J Obstet Gynecol Res. 2009;35(3):453–458.CrossRefGoogle ScholarPubMed
Douma, M, Smith, KE, Brindley, PG.Temporization of penetrating abdomino-pelvic trauma with manual external aortic compression: a novel case report. Ann Emerg Med. 2014;64(1):79–82.CrossRefGoogle Scholar
Blaivas, M, Shiver, S, Lyon, M, Adhikari, S.Control of hemorrhage in critical femoral or inguinal penetrating wounds-an ultrasound evaluation. Prehosp Disaster Med. 2006;21(6):379–382.CrossRefGoogle ScholarPubMed
Douma, M, Brindley, PG.Abdominal aortic and iliac artery compression following penetrating trauma: a study of feasibility. Prehosp Disaster Med. 2014;29(3):299–302.CrossRefGoogle Scholar
Douma, MJ, O’Dochartaigh, D, Brindley, PG.Optimization of indirect pressure in order to temporize life-threatening hemorrhage: a simulation study. Injury. 2016;(47):1903–1907.CrossRefGoogle ScholarPubMed
FIGO Safe Motherhood and Newborn Health (SMNH) Committee. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynecol Obstet. 2012;117(2):108–118.CrossRefGoogle Scholar
Kin, N, Hayashida, M, Chang, K, et al.External manual compression of the abdominal aorta to control hemorrhage from a ruptured aneurysm. J Anesth. 2002;16(2):164–166.CrossRefGoogle ScholarPubMed
Douma, MJ, O’Dochartaigh, D, Brindley, PG.Bi-manual proximal external aortic compression after major abdominal-pelvic trauma and during ambulance transfer: a simulation study. Injury. 2017;48(1):26–31.CrossRefGoogle ScholarPubMed
Lyon, M, Shriver, SA, Greenfield, EM, et al.Use of a novel abdominal aortic tourniquet to reduce or eliminate flow in the common femoral artery in human subjects. J Trauma Acute Care Surg. 2012;73(2 Suppl 1):S103–105CrossRefGoogle ScholarPubMed
Taylor, DM, Coleman, M, Parker, PJ.The evaluation of an abdominal aortic tourniquet for the control of pelvic and lower limb hemorrhage. Mil Med. 2013;178(11);1196–1201.CrossRefGoogle ScholarPubMed
Biffl, WL, Fox, CJ, Moore, EE.The role of REBOA in the control of exsanguinating torso hemorrhage. J Trauma Acute Care Surg. 2015;78(5):1054–1058.CrossRefGoogle ScholarPubMed
Kheirabadi, BS, Terrazas, IB, Miranda, N, et al.Long-term consequences of abdominal aortic and junctional tourniquet for hemorrhage control. J Surg Res. 2018;231:99–108.CrossRefGoogle ScholarPubMed