Abstract

Background: The increasing utilization of endovascular techniques for managing traumatic hemorrhages, particularly resuscitative endovascular balloon occlusion of the aorta (REBOA), underscores the need for effective training tools. Traditional training methods, often high stress and time sensitive, necessitate the development of realistic, accessible simulators. The objective of this study is to develop a REBOA simulator that accurately simulates the entire procedure, and is highly portable, low-cost, and reusable.

Methods: A novel, cost-effective REBOA and endovascular access simulator, termed the Training Resuscitative Endovascular Balloon Occlusion of the Aorta (TREBOA) system, was designed, constructed and evaluated. The system was tested by calculating physiological blood flow and pressure drops using Reynold’s number, and assessing the gear pump’s flow rate at varying voltages. A failure mode effects analysis was also conducted to evaluate safety and reliability, with adjustments made for issues exceeding the defined risk threshold.

Results: Extensive testing confirmed the simulator’s efficacy in replicating realistic physiological flow and pressure responses. Safety and reliability assessments indicated a low risk of operational hazards, with the total construction cost being significantly lower than existing simulators at approximately US$1000.

Conclusions: The TREBOA simulator offers several advantages over current models, including cost-effectiveness, anatomical and procedural fidelity, and the potential for customization. Its design facilitates a wide range of training scenarios, from basic skills to complex procedures, making it an invaluable tool for medical practitioners. This innovation holds promise for expanding access to high-quality training in REBOA and endovascular techniques, ultimately enhancing patient care in trauma settings.

Supplementary material

Supplementary Figures 1–3 and Supplementary Tables 1–4
are available at https://doi.org/10.5281/zenodo.13767089.