TY - JOUR T1 - Authors' Response to Letter to the Editor by Allen <em>et al</em> regarding Joint statement from the American College of Surgeons Committee on Trauma (ACS COT) and the American College of Emergency Physicians (ACEP) regarding the clinical use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) by Brenner <em>et al</em> JF - Trauma Surgery &amp; Acute Care Open DO - 10.1136/tsaco-2018-000172 VL - 3 IS - 1 SP - e000172 AU - Debra G Perina AU - Christopher S Kang AU - Eileen M Bulger AU - Ronald M Stewart AU - Robert J Winchell AU - Megan Brenner AU - Sharon Henry AU - Leonard J Weireter AU - Michael C Chang AU - Michael F Rotondo Y1 - 2018/03/01 UR - http://tsaco.bmj.com/content/3/1/e000172.abstract N2 - We appreciate the thoughts and comments provided by Allen et al in their correspondence to the editor. The care of the trauma patient requires an interdisciplinary approach. The American College of Surgeons Committee on Trauma (ACS COT), along with its partner organizations, such as American College of Emergency Physicians (ACEP), has diligently tried to make trauma center criteria centered on the patient and the multidisciplinary team concept. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has emerged as a potential technique for controlling previously lethal truncal hemorrhage in trauma patients, but its optimal role in the management of hemorrhagic shock has yet to be established. The purpose of the ACS and ACEP joint statement is to keep the focus on patient safety in the use of this device. We believe there is insufficient evidence to support the widespread adoption of REBOA1 in both civilian trauma centers and non-trauma centers where there is not immediate access to definitive hemorrhage control. This stance is due to concerns of the negative consequences of (1) prolonged ischemia and (2) delay of hemorrhage control as documented in published studies.2 In addition, the Joint Trauma Systems Clinical Practice Guideline notes, ‘… there is currently a paucity of evidence to guide the specific length … ER -