Search
Aberdeen Centre for Evaluation

What are the key challenges and opportunities for mounting a trial of prehospital REBOA? A behavioural diagnosis to inform a definitive evaluation

In this section
What are the key challenges and opportunities for mounting a trial of prehospital REBOA? A behavioural diagnosis to inform a definitive evaluation

Trauma is a leading cause of morbidity and mortality worldwide with about 5.8 million deaths globally each year. About one-third of all trauma related death is caused by bleeding, and about a one-third of those deaths are preventable. One way to control bleeding is using equipment called REBOA (which stands for “Resuscitative Endovascular Balloon Occlusion of the Aorta”). REBOA involves passing a small inflatable balloon into the main artery to reduce further blood loss, until surgeons can stop the bleeding. However, when patients die from bleeding it’s usually before they reach hospital. We think using REBOA as soon as possible (i.e. before arriving in hospital) might lead to fewer deaths. To see if this is true, we have to design a full-scale evaluation. Before we can design this evaluation and apply for funding for it, we need to understand the experiences of clinical care teams who have used REBOA to treat patients before they arrive in hospital.  In this proposal we aim to find out from clinical teams: 

  • how they decide which patients to treat using REBOA;  

  • how easy or difficult it is to use REBOA;

  • what the challenges are when patients move from pre-hospital to in hospital; and

  • what they see as the difficulties in doing research in this area and how we might overcome them. 

This project will conduct a behavioural diagnosis of the barriers and enablers in delivering prehospital REBOA and running a trial reported by the P-PRO clinical teams to inform the successful implementation of a future trial. This behavioural diagnosis will provide information on what needs to change for the desired behaviours (for example, recruitment of participants, willingness and ability to deliver the intervention, and future randomisation) to occur. In other words, who needs to do what differently to/for whom and when. 

Contacts

Status

Completed

Publications

Lawrie L, Duncan EM, Jansen JO et al. Behavioural optimisation to address trial conduct challenges: case study in the UK-REBOA trial. Trials 23, 398 (2022). https://doi.org/10.1186/s13063-022-06341-6