Preventing Trauma Deaths

Battlefield medics and emergency responders many times have seen patients with no visible wounds suddenly go into shock from internal bleeding. At that point, no matter how fast medical personnel respond, the patient can still die. By the time, a patient goes into shock, the body has difficulty keeping the brain and heart functioning. Early treatment for shock is paramount to saving lives.

Army researchers at the Institute of Surgical Research are working collaboratively with researchers at the University of Colorado, Children’s Hospital in Colorado, and with Flashback Technologies, Inc. to develop software called a “compensatory reserve index” that can predict when a patient will go into shock.

The index tracks arterial waveforms that are waves of blood pressure created as the heart pumps blood into the vessels. Within 30 seconds, the index can determine the rate at which the patient is using up his compensatory reserve and how the body is compensating for the blood loss when directing blood flow to the heart and brain.

A small screen on the prototype uses green, yellow, and red to denote how much of a patient’s reserve has been used. Green indicates that the patient is still strong, yellow that the patient is weakening, and red that the patient is in imminent danger or going into shock.

According to Lt. Co. Will Smith, an emergency medicine physician in the Army Reserve, the technology could revolutionize how we take care of patients in both the pre-hospital as well as in the hospital setting, If the device can be validated and receive clinical approval, then it has an amazing potential to save lives.

The device is undergoing research to see if the device would be helpful to use during childbirth. Obstetricians often have difficulty recognizing the actual amount of bleeding and predicting how well the mother will be able to compensate during childbirth. Today, collaborative research is underway between the Army Institute of Surgical Research and the Department of Obstetrics at the San Antonio Military Medical Center to test how well the compensatory reserve index tracks blood loss during childbirth.

Clinical trials have been completed on the index and now the results will be submitted the FDA within the next couple of months along with a request for approval of the software as a medical device.

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