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This edition of Trauma Surgery & Acute Care Open contains an article by Hatchimonji et al,1 which describes a retrospective series of patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA), in the emergency department. The study used Trauma Quality Improvement Project (TQIP) data, and included hypotensive adult patients with penetrating abdominal trauma, who subsequently underwent laparotomy. Patients who had REBOA were propensity score matched to patients who did not. These patients experienced longer times to laparotomy, had increased transfusion volumes, an increased frequency of leg amputations, and increased in-hospital mortality.1