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Managing noncompressible torso hemorrhage with REBOA

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doi: 10.1097/01.NURSE.0000659220.45974.0d
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INSTRUCTIONS Managing noncompressible torso hemorrhage with REBOA


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Managing noncompressible torso hemorrhage with REBOA

GENERAL PURPOSE: To present an overview of REBOA in adults experiencing NCTH. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify indications for REBOA. 2. List contraindications for REBOA. 3. Outline the assessment of patients who have undergone REBOA.

  1. NCTH involves trauma-induced bleeding into the chest, abdominal cavity, and
    1. upper extremities.
    2. lower extremities.
    3. pelvis.
  2. REBOA is indicated for traumatic life-threatening hemorrhage in adults who have been unresponsive to standard fluid resuscitation and present in
    1. hemorrhagic shock.
    2. septic shock.
    3. neurogenic shock.
  3. An absolute contraindication for REBOA is a traumatic aortic injury and hemorrhage
    1. distal to the zones of occlusion for balloon inflation.
    2. proximal to the zones of occlusion for balloon inflation.
    3. adjacent to the zones of occlusion for balloon inflation.
  4. A relative contraindication for REBOA is
    1. age over 60.
    2. pulseless electrical activity lasting longer than 2 minutes.
    3. terminal illness.
  5. The area that extends from the celiac artery to the lowest renal artery is Aortic Zone
    1. I.
    2. II.
    3. III.
  6. Occlusion in which Aortic Zone controls blood flow to the abdominal viscera, the pelvic region, and the lower extremities?
    1. I
    2. II
    3. III
  7. Which artery is the most common site for establishing access for the aortic balloon catheter?
    1. radial
    2. carotid
    3. femoral
  8. The typical size of a vascular access sheath for insertion of the REBOA balloon catheter is
    1. 5 Fr.
    2. 7 Fr.
    3. 12 Fr.
  9. Once correct placement has been confirmed, the clinician inflates the balloon with either a balloon inflation medium or
    1. sterile water for injection.
    2. Ringer's lactate solution.
    3. 0.9% sodium chloride solution.
  10. Balloon inflation should continue until
    1. contralateral femoral pulses are absent.
    2. the ipsilateral femoral pulse becomes faint.
    3. BP begins to fall.
  11. The literature suggests that patients with Aortic Zone I occlusions can tolerate occlusion times of up to
    1. 1 hour.
    2. 90 minutes.
    3. 2 hours.
  12. Occlusion of which Aortic Zone is well tolerated for several hours with constant monitoring of distal perfusion?
    1. I
    2. II
    3. III
  13. Complications related to the arterial access required for REBOA include
    1. extremity ischemia.
    2. toxic epidermal necrolysis.
    3. lower gastrointestinal bleeding.
  14. Unintended inflation of the balloon in the iliac vessels may lead to
    1. angioedema.
    2. thrombosis.
    3. focal seizures.
  15. Equipment necessary for REBOA should be bundled into an easily accessible kit that includes
    1. bandage scissors.
    2. two 60-mL syringes.
    3. an arterial pressure monitoring device.
  16. A recommended clinical management guideline for postprocedure assessment includes assessing vital signs every
    1. 15 minutes for the first 2 hours.
    2. 20 minutes for the first 3 hours.
    3. 30 minutes for the first 4 hours.
  17. Complications of reperfusion after REBOA include
    1. fat embolism syndrome.
    2. avascular necrosis.
    3. rhabdomyolysis.
  18. The 5 P's help to identify
    1. rhabdomyolysis.
    2. compartment syndrome.
    3. renal failure.
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