Tiny balloon catheter used by military stops bleeding in trauma patients

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By the point Gaven Mayo received to a Montreal hospital after a bullet from a high-powered rifle ripped by means of his thigh, he had misplaced a large quantity of blood and, by his personal account, was hovering between life and dying.

However the 27-year-old from the Kahnawake First Nation attributes the truth that he did not die to a easy system that may instantly arrest extreme bleeding, giving surgeons time to restore the injury from traumatic accidents and saving lives that in any other case may need been misplaced.

“On the best way to the hospital, I used to be nonetheless mainly dropping blood the entire approach,” he mentioned Wednesday from his mattress at McGill College Well being Centre (MUHC), the place he has been recovering for the final six weeks whereas ready for switch to a rehabilitation centre.

“After I arrived on the hospital, they mentioned I had misplaced about 80 per cent of my blood.”

Mayo declined to speak about how he received shot, however mentioned the bullet handed by means of his leg, breaking his femur and ripping into his femoral artery, the key blood vessel in the leg.

Gaven Mayo says his life was saved by a tool that, authorized by Well being Canada in late 2017, stops extreme bleeding. (Submitted by the MUHC)

He may need fatally bled out have been it not for MUHC medical doctors utilizing a newly adopted system, a balloon catheter that’s inflated contained in the aorta — the physique’s main artery — to halt all blood move under the extent of the diaphragm.

Versatile tube is fed into femoral artery

The system — generally known as the ER-REBOA catheter — is fabricated from a skinny versatile tube topped by a tiny inflatable balloon, which is fed into the femoral artery in the groin earlier than being snaked into the aorta, in the identical approach an angioplasty catheter is launched to open up blocked coronary arteries in individuals with coronary heart illness.

“The job of the angioplasty balloon is to dilate the artery to get it to open up; this one is to only occlude the artery and block the move (with) the balloon so that you cease bleeding,” mentioned Dr. Andrew Beckett, an MUHC trauma surgeon who launched the ER-REBOA system to the hospital.

Beckett mentioned it takes solely two minutes to get the catheter inserted and the balloon blown up, shopping for important time for surgeons to get a affected person to the working room to restore a smashed organ or pelvic fracture, for instance, that has prompted a extreme hemorrhage.

“You’ve got received a window of about 45 minutes to an hour to get management of the bleeding and get the balloon (out),” he mentioned.

“These are very sick patients and in a number of circumstances, if you do not get the balloon up, the affected person can exsanguinate in 5 minutes.”

The system is designed not solely to cease bleeding in the decrease half of the physique, however to maintain blood circulating to the mind, coronary heart and lungs, he mentioned, including that after the balloon is inflated, a hemorrhaging affected person’s dangerously low blood strain normalizes and their coronary heart fee comes down.

“This can be a therapy for hemorrhagic shock,” mentioned Beckett. “While you’re having hemorrhagic shock, it is like a whole-body stroke or coronary heart assault.”

Used by U.S. military in Iraq and Afghanistan

Beckett, a lieutenant-colonel in the Royal Canadian Medical Providers and chief of common surgical procedure and trauma for the Canadian military, was chargeable for introducing the catheter to his hospital after listening to it mentioned, particularly in relation to U.S. fight accidents in Iraq and Afghanistan.

As soon as the system acquired Well being Canada approval in late 2017, trauma medical doctors at MUHC started coaching in its use, mentioned Beckett, who believes the Montreal hospital is the one one in Canada using the hemorrhage-stopping instrument thus far.

He mentioned U.S. medical doctors have used the catheter greater than 2,000 instances, ensuing in “a number of spectacular saves,” together with girls who’ve skilled ruptured uteruses resulting from motorcar accidents. The Canadian military has additionally used it in Iraq.

The system has been employed on the battlefield to stave off bleeding in military personnel injured by IED blasts, permitting them to be stabilized sufficient to have them airlifted by helicopter to a subject hospital.

“We’re not prepared for this in Canada but, however some international locations like the UK have put the catheter in pre-hospital environments and introduced the patients to trauma centres,” Beckett mentioned.

The ER-REBOA Catheter is “designed to be used in the emergency and demanding care setting and is optimized to help fast and speedy hemorrhage management,” states the Prytime Medical Units web site. (Submitted by Prytime Medical Units )

With out the system, surgeons must crack open a affected person’s chest in order to clamp the aorta, an invasive process that’s onerous on patients and takes many weeks to heal.

“This can be a way more elegant approach,” he mentioned. “By permitting us to quickly management bleeding, (the catheter) saves lives, requires fewer blood transfusions and reduces morbidity related to main open surgical procedure.”

Mayo, an iron employee who has a five-year-old daughter, believes utilizing the catheter saved his life.

“To be sincere, I imagine I’d be dead. I am extraordinarily grateful that they determined to make use of that.”

https://www.cbc.ca/news/canada/montreal/er-reboa-catheter-saves-lives-muhc-1.4743697?cmp=rss

 

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