LAUSR

A s with its original description in 1954, the modern development of resuscitative endovascular balloon occlusion of the aorta (REBOA) emerged from the crucible of war. Early in the Afghanistan and Iraq Wars, data from the military's Joint Trauma System and registry showed that 25% of wounded service members died from potentially survivable injuries, 90% of those from uncontrolled bleeding before reaching surgical care. Although the military had established themost comprehensive casualty care system in history, it was not working for service members with noncompressible torso hemorrhage and shock who required rapid intervention to support blood pressure and bleeding control before the operating room. Despite advances in blood component-based resuscitation, the otherwise surgery-centric paradigm of “get the patient into the operating room as soon as possible” needed reappraisal and new approaches.