The Concept of Endovascular Resuscitation and Trauma Management: Building the EVTM Team

Abstract

Uncontrolled major hemorrhage resulting in hemodynamic instability is a major challenge with an associated high morbidity and mortality rate. Traditional resuscitation practices are in urgent need of further optimization. Endovascular procedures and techniques, as well as the EndoVascular resuscitation and Trauma Management (EVTM) multidisciplinary concept, have been introduced into trauma care. With improved imaging technology, EVTM has been suggested to result in faster bleeding control, minimized blood loss, and less extensive surgical insult. The application of EVTM is, however, highly dependent on the skillset and capabilities of the managing team or center, as well as the resources available. As an adjunct to conventional trauma protocol, Advanced Trauma Life Support (ATLS) and Definitive Surgical Trauma Care (DSTC), these practices can be utilized in conjunction for achieving hemorrhage control. This, however, necessitates the acquisition of appropriate knowledge and hands-on training. Major trauma, hemorrhage, and other causes of hemodynamic instability present major challenges for physicians, requiring multidisciplinary team work during all phases from initial resuscitation to definitive treatment. As a community, there is a need to collaborate for further development and optimization of these advanced methods for bleeding control and hemodynamic stabilization.