Assessing the Awareness of EVTM Practices Among Emergency Medicine Physicians in Turkey

Abstract

Background: Trauma is the leading cause of death in those aged 1–44 years; nearly half of these fatalities are due to bleeding. As resuscitative endovascular balloon occlusion of the aorta (REBOA) and other endovascular resuscitation and trauma management (EVTM) methods became known in Turkey, they started to arouse interest. The main objective of this study is to reveal the impressions of emergency medicine (EM) doctors about EVTM and REBOA application possibilities, and the secondary objective is to determine the issues that are limiting their spread. Methods: We conducted a 22-question cross-sectional survey via e-mail between 1 January and 1 April 2020. The questions were formulated to be closed-ended, semi-closed-ended, and open-ended. The evaluation questions utilized 3- and 5-point Likert scales and Yes/No questions. EM specialists, residents, consultants, and physicians working as emergency department (ED) directors in Turkey were included. EM specialists working in units other than EDs and specialists from other branches were excluded. Results: Among the 512 people contacted for this study, 132 agreed to participate. The numbers of participants that were aware of REBOA and EVTM were 114 and 99, respectively. Participants thought that femoral vascular access, extracorporeal membrane oxygenation (ECMO), and REBOA were more applicable in EDs (median 4, 4, and 4.5, respectively; interquartile range 1–5). Participants considered lack of knowledge and skills and lack of equipment as barriers to REBOA (median 5 and 5, respectively). Conclusions: To disseminate EVTM practices in Turkey, projects should be conducted primarily to address lack of knowledge, skills, and equipment.