Bleeding control in catastrophic blunt pelvic trauma using the abdominal aortic and junctional tourniquet in a civilian level I trauma center: A case report.

BACKGROUND

In non-compressible blunt pelvic trauma with hemodynamic instability there are few options to ensure bleeding control in the prehospital setting or the emergency bay. These include insertion of a balloon into the descending aorta to achieve occlusion and loss of blood flow distal to the device known as resuscitative endovascular balloon occlusion of the aorta (REBOA). An alternative is the use of an external abdominal aortic and junctional tourniquet (AAJT) which is inflated to produce compression of the aorta.

CASE PRESENTATION: We present the case of a 27-year-old patient, who was transferred to our emergency department by local emergency medical service after a fall from ten meters height onto concrete. The patient presented in hemorrhagic shock due to intrapelvic bleeding. Temporary bleeding control using the AAJT was initiated in the emergency bay, and after initial imaging, the patient was taken to the operating theatre for definitive bleeding control with improved vital signs following tourniquet inflation.

CONCLUSIONS

This case report suggests, that the use of the AAJT in civilian setting is feasible and could act as an alternative to other methods of temporary pelvic bleeding control, including invasive procedures like the REBOA.