Lifesaving Balloon Catheter Device Added to Museum

By Lauren Bigge
NMHM Public Affairs Coordinator

During the episode “The Fog of War” of the CBS drama series Code Black, two characters quickly decided to use a “balloon-tipped catheter” for “REBOA” to save a patient. The concept: a balloon that temporarily stops major bleeding in the aorta of the heart. It’s a device that can save lives and it’s a story that started with the American military. The U.S. Army Medical Research and Materiel Command’s Combat Casualty Care Research Program (CCCRP) and Code Black’s head writer-executive producer were even in touch about the episode’s accuracy, which turned into a mutually-beneficial partnership.

Resuscitative Endovascular Balloon Occlusion of the Aorta catheter stops internal hemorrhaging that cannot be stopped using either conventional or junctional tourniquets. National Museum of Health and Medicine photo by Matthew Breitbart

Military service members developed the small balloon-tipped catheter into its current state-of-the-art form due to the need for a piece of equipment that could be used in a battlefield environment to rapidly slow internal bleeding, without damaging vital organs, long enough for a patient to receive life-saving care. The ER-REBOA is used for the procedure called “Resuscitative Endovascular Balloon Occlusion of the Aorta,” to stop hemorrhaging that cannot otherwise be stopped using either conventional or junctional tourniquets.

“This works for a class of wounds you can’t put a tourniquet on,” said Alan Hawk, who manages the Historical Collections at the National Museum of Health and Medicine. NMHM is the Department of Defense’s military medical museum and is an element of the Defense Health Agency.

“If you’re in a situation in the field and you couldn’t clamp the artery, this would let you do it. It’s the sort of innovation unique to military medicine that will save lives on the battlefield and, possibly, become a common practice elsewhere,” Hawk added.

Col. Todd Rasmussen, a vascular surgeon, former CCCRP Director and current Associate Dean for Research at the Uniformed Services University, told the NMHM’s May 2016 Medical Museum Science Café program audience that while the origins of a balloon aortic occlusion device were reported during the Korean War in the 1950s, emergency endovascular capabilities were nonexistent in 2003 and 2004 at the beginning of the Iraq and Afghanistan wars.

“We’ve known hemorrhage has been a cause of death for a long time,” Rasmussen said. “We wanted to be able to place this [balloon catheter] without an X-ray, make sure it didn’t need an additional wire, and be able to have it as an arterial line. This is placed through a small puncture in the femoral artery, instead of a big incision. In that way, it might be used by medics outside of a hospital.”

Hawk requested an ER-REBOA to add to the museum’s collection of artifacts documenting the history of combat casualty care. The ER-REBOA was received at NMHM in January 2017.

“This device is a continuation of our collection documenting the history of hemorrhage control,” said Hawk. The museum collection includes over 155 artifacts ranging from 19th century tourniquets used for amputations to hemostatic forceps used in surgical procedures. The Department of Defense’s pioneering role in controlling blood loss during pre-hospital care is represented by the development of hemostatic bandages and new types of tourniquets first used during the conflicts in Afghanistan and Iraq. Civilian first responders are benefiting from the military’s “lessons learned” in the area of bleeding control through the DoD-supported “Stop the Bleed” campaign.

Maj. Timothy Williams, left, and Maj. Lucas Neff, right, perform bench top testing of balloon catheters at Travis Air Force Base, Calif., using a custom-made blood flow simulator. U.S. Air Force photo by Senior Airman Amber Carter

Air Force surgeon Joseph DuBose used ER-REBOA at the University of California Davis Medical Center to save a trauma victim’s life in February 2016.

“ER-REBOA stabilizes the patient for a short period of time,” Rasmussen said during his NMHM presentation. “It allows the patient to survive in time for an operation.”

The museum is working on incorporating the artifact and its story into an exhibit on advances in military medicine.


RELATED LINKS: Army’s Trauma Innovations are Saving Lives on the Battlefield
A Tiny Device Could Save Precious Moments During Combat Traumas
Patient Credits WBAMC with Saving Life

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