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REBOA at Role 2 Afloat: resuscitative endovascular balloon occlusion of the aorta as a bridge to damage control surgery in the military maritime setting
  1. Paul Rees1,2,
  2. B Waller3,
  3. A M Buckley1,
  4. C Doran4,
  5. S Bland5,
  6. T Scott6 and
  7. J Matthews7,8
  1. 1 Academic Department of Military Medicine, London, UK
  2. 2 University of St Andrews School of Medicine, St Andrews, UK
  3. 3 Shackleton Department of Anaesthetics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4 Department of Surgery, Royal Centre for Defence Medicine, Birmingham, UK
  5. 5 Department of Emergency Medicine, Queen Alexandra Hospital, Portsmouth, UK
  6. 6 Department of Anaesthesia and Critical Care, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
  7. 7 Department of Orthopaedics and Trauma Surgery, Royal Cornwall Hospitals NHS Trust, Truro, UK
  8. 8 Clinical Director Role 2 Afloat, National Command Headquarters, Portsmouth, UK
  1. Correspondence to Paul Rees, Academic Department of Military Medicine, London EC1A 7BE, UK; cardiacexpert{at}


Role 2 Afloat provides a damage control resuscitation and surgery facility in support of maritime, littoral and aviation operations. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers a rapid, effective solution to exsanguinating haemorrhage from pelvic and non-compressible torso haemorrhage. It should be considered when the patient presents in a peri-arrest state, if surgery is likely to be delayed, or where the single operating table is occupied by another case. This paper will outline the data in support of endovascular haemorrhage control, describe the technique and explore how REBOA could be delivered using equipment currently available in the Royal Navy Role 2 Afloat equipment module. Also discussed are potential future directions in endovascular resuscitation.

  • endovascular resuscitation
  • resuscitative endovascular balloon occlusion of the aorta
  • reboa
  • damage control surgery
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  • Contributors All authors took an equal role in discussion of the concepts, composition, generation and review of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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