www.c4ts.qmul.ac.uk
C4TS Newsletter Winter 2018 Issue 15
C4TS RESEARCH NEWS WINTER 2018 In this edition of our newsletter, we discuss our involvement in the U.K REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) trial. The trial aims to shed light on whether this innovative method for stemming internal haemorrhage post-injury is more effective than standard clinical practice. C4TS researchers have also been examining how patients with traumatic brain injuries are triaged in London hospitals to determine any variations in outcomes and we outline our findings. We also share some education highlights from our MScs in trauma sciences and media coverage of our research.
UK-REBOA Trial
by Major Max Marsden, Clinical Research Fellow
A new technique for controlling internal bleeding after major injury is the subject of a new clinical trial. Uncontrolled bleeding is a leading cause of preventable death following major injury. Military experience has shown that the use of tourniquets improves survival, by stopping bleeding before surgery. However, tourniquets are only effective at stopping bleeding from the extremities, they are no use when the bleeding is inside the torso. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a new technique designed to stop internal haemorrhage. REBOA involves passing a small inflatable balloon into the aorta (the main artery in the body) to stop the bleeding until a patient can be taken to an operating theatre. While REBOA has shown early promise, we do not yet know whether it is better than standard care given to trauma patients. The UK REBOA trial aims to
Dr Samy Sadek, Consultant in Emergency Medicine and Prehospital Care at Barts Health, demonstrates REBOA techniques to paramedics at the Royal London Hospital. compare standard major trauma care that includes REBOA to standard major trauma care alone. The study has been designed by Chief Investigator Jan Jansen and researchers from Aberdeen University. It has some unique challenges, such as conducting a Randomised Controlled Trial in critically injured patients with an extreme time pressure to intervention, and only including those patients thought to have exsanguinating (life-threatening) haemorrhage. Because patients such as these are a relatively rare in the UK, Dr Jansen has designed the trial using a Bayesian design that is very different to the majority of clinical trial designs. A Bayesian design allows relatively small numbers of patients to be enrolled in the study while still producing meaningful evidence of the effect of REBOA. The trial expects to involve approximately 120 patients, across 10 Major Trauma Centres, over four years. (con’td p2)
SAVE THE DATE The second London Major Trauma System symposium will be held at the Royal Geographical Society, South Kensington, London on 12th June 2018. More information available on www.londontraumasystem.org
C4TS Newsletter Winter 2018