The majority of casualties on the battlefield die from uncontrolled bleeding. Analysis of data from conflicts in Iraq and Afghanistan indicates that about 22 percent of service members who died following severe bleeding after injury could have potentially been saved had their hemorrhaging been controlled early on.
The Biotechnology High Performance Computing Software Applications Institute (BHSAI) http://bhsai.org one of the Telemedicine & Advanced Technology Research Center’s (TATRC) www.tatrc.org key labs, is addressing how to identify patients with severe bleeding during transport.
BHSAI is developing the “Automated Processing of the Physiologic Registry for Assessment of Injury Severity (APPRAISE) system. APPRAISE is an artificial intelligence-based system that can alert medics when trauma patients are in need of massive blood transfusions without any human intervention.
The system collects and analyzes in real-time vital sign information from the patient during pre-hospital transport. The system uses the results of that analysis to determine if the patient will need a massive blood transfusion before the patient arrives at the hospital.
According to Dr. Jaques Reifman PhD, BHSAI Director, the system consists of an off-the-shelf vital signs monitor connected to a ruggedized PC running Microsoft Windows. “A benefit of the system is that it uses standard vital signs such as EKG, heart rate, and blood pressures which caregivers are already familiar with. There is no need for training care givers to new sensor modalities so APPRAISE can be easily disseminated throughout the healthcare system.
The research team has worked with Boston MedFlight www.bostonmedflight.org, a not-for-profit organization operating in Boston and New England. For nearly two years, the APPRAISE system was used in MedFlight helicopters to monitor trauma patients during emergency transports. Patients were then transported to one of three hospital partners including Massachusetts General Hospital, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center.
By comparing clinical and trauma registry data with computer predictions, BHSAI scientists found that the APPRAISE system was able to automatically identify casualties in need of massive blood transfusions with 78 percent sensitivity and 90 percent specificity within ten minutes of the start of transport to the trauma center. This was the first time that anyone not just the Army had been able to collect and analyze data in real-time as patients were being transported.
The BHSAI team has received two patents for the APPRAISE system, applied for FDA approval, and seeks a licensing agreement with a commercial partner. More information about the APPRAISE system trial will be documented in the May 2015 issue of the journal “Shock”.