Pre-Hospital and Emergency Endovascular Resuscitation Course - PEER Course

In 2015 the Institute of Pre-Hospital Care created the PEER course.

The operational team performed the first pre-hospital REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) procedure in 2014.  The procedure involves inserting and inflating a balloon into the aorta, the largest blood vessel in the body via the femoral artery in the groin. The procedure had previously been performed at the Royal London Hospital and in a small number selected regional trauma centres worldwide.

Patients who would otherwise die from catastrophic bleeding from the pelvis and the lower limbs can benefit from this procedure. It is recognized that in patients who are extremely ill. REBOA is a technically challenging intervention that requires a great deal of expertise to perform correctly.

In the operational side of the service, the procedure is enveloped in a stringent clinical governance structure that ensures delivery of the intervention is as safe as possible for patients. Our doctors and paramedics undertake significant training and assessment prior to being permitted to perform REBOA.

The PEER course brings together experts from around the world including colleagues who have pioneered REBOA in Australia, Japan, the United States of America together with those who have written academic papers on the subject. The course is only available to clinicians who practice REBOA as part of their emergency work. The PEER course is a collaboration between Queen Mary University London, Barts Health NHS Trust and the Institute of Pre-Hospital Care at London's Air Ambulance. 

The course includes:

  • Lectures from the experts who pioneered the pre-hospital procedure
  • Masterclasses on technique
  • Ultrasound workshops
  • The use of cadavers to revise anatomy, landmarks and to discuss potential patient cases
  • Sections on research related to REBOA
  • Practical skill stations
  • Fully immersed simulation training in the pre-hospital and emergency department phases of care
  • Large group expert panel discussions

The course faculty includes leaders in the pre-hospital field, interventional radiologists, trauma surgeons, paramedics and nurses. 

25 candidates successfully completed the 2015 course with a further 25 completing the second course held in January 2017. Both courses were accredited for continuing professional development by the Royal College of Emergency Medicine.