Table 1

Considerations for use of REBOA at the echelons of care

Role type	Description of role	Advantages of use	Disadvantages of use
Role 4	Definitive medical care Located outside of theatre	Definite surgeon involvement May avoid morbidity of a thoracotomy Less risk of physician injury compared with thoracotomy	Could delay a necessary thoracotomy Unlikely required at this level of care
Role 3	Specialist surgical and medical capabilities Intensive care capabilities Holding capabilities	Definite surgeon involvement May avoid morbidity of a thoracotomy Less risk of physician injury compared with thoracotomy Military experience with REBOA in this environment	Could delay a necessary thoracotomy
Role 2	Damage control resuscitation Basic imaging and laboratory capabilities Short-term holding of patients	Likely surgeon involvement May avoid morbidity of a thoracotomy Less risk of physician injury compared with thoracotomy Military experience with REBOA in this environment	Could delay a necessary thoracotomy
Role 1	Primary care Emergency resuscitation Preparation for evacuation	Performed by a physician After initial damage control resuscitation Opportunity for prophylactic placement May allow more patients to survive to surgical care	Patients not evaluated by a surgeon May delay transport May be used unnecessarily Danger of prolonged ischaemia if evacuation delayed
Role 0	Point of injury care	Earliest possible non-compressible haemorrhagic control Opportunity for prophylactic placement May allow more patients to survive to surgical care	Performed by non-physician Before adequate resuscitation May delay transport May be used unnecessarily Danger of prolonged ischaemia if evacuation delayed Difficult to deploy and use in tactical environment

REBOA, resuscitative endovascular balloon occlusion of the aorta.