Portable Battlefield Surgery Kit

One of the good things of working in Houston is we have multiple Level One Trauma Centers in case of major injury. If you get shot, stabbed, crushed or burned, you go to Ben Taub or Hermann Memorial. Now I found this interesting and one of the bad things for smaller departments (or state police units) is they may not have emergency facilities available nearby. Time can mean life. Something like this may very useful to smaller, more isolated agencies.

Nicole Ribeiro, an anesthesiologist, demonstrates how a tablet
computer can help evaluate a burn patient when used with other
miniaturized medical tools. Nick de la Torre / Houston Chronicle

Dr. George Kramer shows a miniaturized high-rate IV pump, which is
used to help burn patients in John Sealy hospital in Galveston.

Emergency room in backpack being developed for battlefield

GALVESTON — Marines seriously wounded in remote areas of the world, hours or even days from emergency room care, can find their lives slipping away.

New tactics developed by the Marine Corps that emphasize smaller, highly mobile units operating in distant lands make the need for better medical care closer to the battlefront even more important.

That care is on its way in the form of an emergency room in a backpack being developed in part by a team of doctors at the University of Texas Medical Branch. It’s part of an effort to bring close to the front lines treatment normally found only in the best hospital emergency rooms. The effort already has produced life-saving equipment.

“This is really a big breakthrough,” said Dr. Kim Bentley, program officer at the Office of Naval Research in Arlington, Va.

The object of the effort is to reduce the size of bulky monitors and other life-saving equipment normally found in a hospital emergency room so that they can fit in a backpack. Eventually wounded Marines could be hooked up to the automated system and it would keep them alive while they were transported to the nearest aid station.

One possibility under consideration is attaching the equipment, known as the Automated Critical Care System, to a drone that would carry the patient to a hospital ship.

“It’s robot airplanes and robot medical care at the extreme part of this vision,” said Dr. George Kramer, a researcher who pioneered two key components of the system. Although the Office of Naval Research is leading the development of the system, it would be available to all branches of the service and eventually to civilian first responders, Bentley said.

Small enough to carry

The idea is for miniaturized medical devices to be connected to a core computer. Devices would monitor vital functions such as breathing and heart rate as well as administering blood and saline solution, drugs and anesthetics, among other medical tasks.

The entire system must be small enough to fit into a backpack. The device could work on its own without human intervention or give information to a caretaker. It could also link to specialists.

University of Texas Medical Branch is developing the devices that monitor and dispense fluids and drugs, the University of Cincinnati is working on devices that assist with breathing, and Iowa-based Athena GTX is working on the core computer, Bentley said.

A helicopter picking up wounded could be equipped with the system, which would give doctors information about the injury earlier than was previously possible.

“The great thing about this whole setup is that it provides a medical record from the point of injury onwards,” said researcher Dr. Michael Kinsky. “We don’t have any information now at the point of injury. It’s a big black box.”

Vital signs monitor

Kramer developed a component known as the Burn Navigator, which monitors a burn patient’s fluids and automatically replaces them. The device was recently approved for use by the U.S. Food and Drug Administration. He developed a second device to monitor blood pressure and replace blood. The device consists of a wireless vital-signs monitor with a cuff that transmits information to a computer tablet about the size of an iPad. The computer analyzes information from the monitor and sends instructions to a small pump.

Kinsky is testing the blood system on volunteers and the results are promising, with no complications in about 50 experiments, he said.

Another group of the hospital’s researchers is turning the best available medical knowledge into algorithms — mathematical computations that can create software for the Automated Critical Care System.

Houston-based Arcos Inc. has adapted the rugged Panasonic Toughbooks for use as the trauma tablets to control the blood system device. Arcos is using the hospital algorithms to develop the tablet software.

The device can operate on its own, but it will know when human assistance is needed, Arcos CEO Chris Meador said. Arcos is manufacturing the Burn Navigator and will manufacture the blood system device....