Defense Tech » Medic!

A Blood Transfusion in a Pill

christian — Fri, 29 Jan 2010 14:43:18 +0000

Well, not quite, but close.

Got a tip from a reader about a potentially revolutionary new drug that could prolong the life of a human who’s bleeding out from a severe wound.

According to an article in the New Scientist, medical professionals are experimenting on a pill that can trick the body into thinking it’s not in shock when it really is. In other words, the drug can prevent certain mechanisms within the proteins and DNA from permanently breaking down and causing long-term damage when the victim is resuscitated.

When the body loses a lot of blood, it tries to compensate by going into shock. This is a set of emergency measures to raise blood pressure and conserve energy, such as increasing heart rate and shutting down expression of some proteins. However, if the body stays in shock for more than a short time, it can lead to organ failure, and death soon follows.
Recent studies have suggested that around 6 or 7 per cent of genes change their expression in response to shock, via the removal of “epigenetic”, chemical additions to the genome called acetylations. As histone deacetylase (HDAC) inhibitors can prevent the removal of such acetylations, Alam wondered if these drugs might improve survival after blood loss.
His team previously showed that valproic acid, an HDAC inhibitor already used to treat epilepsy, increased survival rates in rats that had lost a lot of blood. It seemed to be doing this by preventing acetylation, causing certain “survival pathways” to remain switched on.

The combat medical applications for a drug like this are obvious. The US military has already done an amazing job at lowering the death rate of troopers wounded in hideous explosions and ambushes, including the near ubiquitous fielding and training on the use of tourniquets and lots of combat first aid training. The military medical establishment has also done a lot to speed the process of getting an IED-struck Joe, for example, from route Michigan in Ramadi to Ramstein in literally hours.

But a breakthrough like this could mean the difference between life and death for wounded troopers in more remote locals with fewer medivac options, like Afghanistan. If this proves to work, it could be as revolutionary at Quik Clot and pocket tourniquets.

– Christian

‘Pixie Dust’ May Regrow Fingers

paisley — Wed, 28 May 2008 12:07:40 +0000

Interesting medical item running over at Military.com:

(UPI) Doctors at Brook Army Medical Center are testing a regeneration powder that could help injured soldiers regrow fingers and other body parts lost in battle.
The powder, nicknamed ‘Pixie Dust’ after the fairy dust that enabled children to fly in Disney’s Peter Pan, is made from tissue extracted from pigs. It attracts stem cells and convinces them to grow into the tissue that used to be there, CNN reported May 27. Doctors at BAMC used the powder last week on a wounded Soldier to encourage the regeneration of a finger in lost in Iraq.
“If it is next to the skin, it will start making skin. If it’s next to a tendon, it will start making a tendon, and so that’s the hope, at least in this particular project, that we can grow a finger,” Dr. Steven Wolf told CNN.
Doctors said they are watching patients for unexpected side effects, such as cancer.

(Tinker Bell image courtesy of the Walt Disney Company.)

– Ward

New Tech for Wounded Warriors

paisley — Thu, 19 Jul 2007 12:10:32 +0000

I have a buddy who lost an arm to a mine in Vietnam and now heads the VA’s prosthetics programs. While hunting deer a couple of years ago in West Virginia he explained to me that although the new body armor has saved many lives in Iraq and Afghanistan it has also caused a greater percentage of amputations across the population of wounded than previous conflicts because of the way the shock of an explosion is transferred to the extremities.

Resultantly there is a great demand for prostheses, and from demand comes innovation. Modern technology has afforded wounded warriors devices that are increasingly capable of replicating the performance of human limbs — a huge quality of life issue for these heroes.

Otto Bock HealthCare, a company that started out providing devices for German World War I veterans in 1919, has developed a prosthetic knee system that is an upgrade to its already popular C-Leg. According to an Armed Forces Press Service release “the prosthesis is for above-the-knee amputees and uses a microprocessor to control the knee’s hydraulic functions and anticipate the wearer’s actions and make changes in real time.”

The new system has more sensors, a faster hard drive, and more memory. Engineers are also looking to improve battery life to 50 hours per charge. The release states the leg will “improve transitions between movements like level-ground walking, climbing stairs, and running.”

Barring any technical problems, the new prosthesis should be available to servicemembers in 2009.

– Ward

Iraq’s Deadly Germs

hambling — Tue, 23 Jan 2007 20:20:24 +0000

As anyone who’s ever read Guns, Germs, and Steel will tell you, bacteria and viruses have long been a part of combat — some times, the nastiest part. During the waning days of World War I, the flu sent 70,000 American troops to the hospital; one-third never recovered. In the Civil War, twice as many troops died from disease as from gunshots.
Today’s problems aren’t nearly so severe, in comparison. Since th invasion of Iraq, “more than 700 US soldiers have been infected or colonized with [the bacteria] Acinetobacter baumannii,” Steve Silberman reports in the current Wired magazine. “The Armed Forces Institute of Pathology has recorded seven deaths caused by the bacteria in US hospitals along the evacuation chain.“
But it’s the way that the American military officials have dealt with the bug’s release that’s particularly disturbing. “For a long time, the DoD claimed that the bacteria… was a naturally occurring organism in the Iraqi soil that infected soldiers when they were wounded by IEDs,” Silberman tels Defense Tech. “As you’ll see, this is not the case, and the DoD has known the true source of the infections — the combat support hospitals in Iraq themselves — for over a year and a half.“
One marine’s mom was told her son died of “injuries as a result of enemy action.” Turned out, it was Acinetobacter, instead.
Now, this isn’t the first time the military has mislead families about how their kin were killed. Pat Tillman is probably the most famous example of this in recent years. First, the Tillmans were told he died from enemy fire; then, from friendly; now, murder isn’t being ruled out. But there are many, many others. The question is: Why lie?
(Big ups: XJ)

60 Minutes Covers the “Golden Hour”

christian — Mon, 30 Oct 2006 23:01:42 +0000

It’s no secret that the military’s trauma units have saved the lives of thousands of injured service members and Iraqi civilians whose wounds would likely have killed them in earlier conflicts.
But last night, 60 Minutes ran a powerful 13 minute piece on the doctors, nurses and medics who operate in theater and on the field helicopters. The ~~Hueys~~ UH-60 Blackhawks are stationed around Iraq so that no casualty is more than 25 minutes from a helicopter, helping to ensure that injured soldiers are treated in a hospital within 60 minutes, known as the “Golden Hour.“
The piece focuses on two American soliders, Kenny Lyon and Brad Fulks. Lyon was hit by a mortar while fixing his vehicle, and lost half his blood through three severed arteries before arriving the Air Force theater hospital on the Balad Air Base north of Baghdad.
Fulks was hit by a roadside bomb, which burned the skin over half his body and destroyed one of his lungs.
The Balad Air Base trauma center sees 300 trauma cases a month, but sends many via C-17s transformed into airborne medical centers to Germany. In the Vietnam war, it took an average of 40 days to get wounded soldiers back to the States; in the Iraq war, it now averages three days.
You can read a transcript of the piece here, but I highly recommend watching the video, even if you already know the extraordinary efforts of the military’s trauma teams.
– Ryan Singel

Insta-Blood for Israeli Troops

david_axe — Tue, 25 Jul 2006 17:52:24 +0000

“In about two years’ time, Israel Defense Forces soldiers may carry with them to the battlefield packets with their own powdered blood,” says Ha’Aretz.
“The idea is to take a soldier’s blood, freeze it in laboratory conditions, take out the ice crystals leaving only the blood components. It will look like freeze-dried coffee in a little bag,” said Lieutenant colonel Amir Blumenfeld, head of the IDF medical corps’ trauma unit.
Every soldier going to battle will receive a packet with his own freeze-dried blood as part of his mandatory personal kit, much like the staple personal bandage.
When necessary, if the soldier is wounded in battle and needs blood, a medic or doctor could take out the dried blood bag, mix it with physiological water and inject the soldier with a transfusion of his own blood.
Hey doctors: is this even possible? Weigh in here…

PTSD Treatment: Fear Drug, Virtual Reality

david_axe — Thu, 13 Jul 2006 05:28:02 +0000

Could some time in a computer-generated world while on a fear-fighting drug help troops deal with post-traumatic stress disorder? Emory’s Dr. Barbara Rothbaum University of California’s Dr. Charles Marmar think so.
A tuberculosis drug called D-cycloserine, or DCS, could be the key, notes Army Times.

DCS affects what are called NMDA receptors, key parts of the brain mechanism that controls memory and learning…
The intention is to allow DCS to inhibit fear receptors in the brain so patients can deal with painful memories in a constructive way and essentially “unlearn the fear response” when it comes to their war memories…
Veterans participating in both experimental treatments will be given 50-milligram doses of DCS about half an hour before therapy, as well as exposure therapy…
At Emory, patients will undergo virtual-reality exposure therapy, in which a helmet display with sound effects will put them back in Iraq in one of three scenarios: a solo Humvee ride, a convoy or urban warfare…
Each Emory patient will go through five total sessions four with the DCS and virtual reality and one preliminary therapy session, she said. The study is expected to take five years and include about 150 patients, although the number could expand, she said…
Rothbaum has already used the combination of DCS and virtual-reality therapy on patients who have a fear of heights. She said patients in that study were “significantly better” even three months later, when they were exposed to heights without DCS.
“That gave us a lot of hope,” she said. “So now were trying something more complicated.”

Training is Gross!

hambling — Fri, 16 Jun 2006 18:45:27 +0000

A patrol from the 1st Cavalry Division is held up at an intersection blocked by a wrecked car when a roadside bomb goes off, throwing civilians to the ground. Medics rush to treat the wounded while gunners engage insurgents. One injured civilian squirts blood from a severed limb. Another clutches his intestines spilling from a belly wound.
It’s just another day at the Joint Readiness Training Center at Fort Polk in Louisiana. The blood and bombs are Hollywood special effects, the civilians are actors and the insurgents are contractors. But the stress and horror in the medics’ eyes are real.
“The battlefield effects give you the look, feel and smell of combat,” says JRTC Col. Wayne Detwiler. “Though [the medics] are very well trained, they might have never seen trauma. You’ve got to get them over that.“
One male medic applies a tourniquet to the simulated severed limb (the actor is a Vietnam vet amputee) then moves on to the gut wound. Female Spec. Marin Van Camp follows up behind him with a team, lifting the injured onto stretchers then loading them into a Humvee ambulance. She yells at her team to work faster. Her eyes are wide and her skin flush.
With the casualties all secured, the patrol moves out, speeding to a nearby landing zone. Two UH-60 Blackhawk helicopters flare in to evacuate the wounded.
Van Camp takes a breather. “As long as you know you’re going to see casualties … as long as you’re prepared, it’s easy.“
She’s lying. And soon after the choppers have disappeared over the horizon, the soldiers mount up and continue their patrol. Van Camp’s work isn’t finished.
JRTC Command Sgt. Maj. Matthew Pelletera explains all the blood and guts. “You can replicate an amputee by having a guy hold his leg up, but the effect lasts only so long,” he says. “As a medic, you do so much practice, it feels like it’s not real.“
Not so at JRTC. “Here we replicate live battlefield trauma.“
Read more on the front page of today’s The Washington Times. Go to Flickr for pics. And check out my graphic novel WAR FIX for scenes of real battlefield gore.
–David Axe

Squishy Sacks of Goo …

hambling — Sun, 23 Apr 2006 22:37:33 +0000

… is really all we are. And on the battlefield, there are lots of hot pokey objects that can puncture our squishy sacks, letting out all the goo. To put this problem in more clinical terms: blood loss is the first and most immediate danger to injured troops. Therefore, finding ways of staunching the flow of blood from battered bodies is one of the military medical community’s major priorities.
There’s been a lot of advancements on this front in the past couple years, much of it motivated by the high proportion of bleeding limb injuries in Iraq and Afghanistan. Several advancements have been mentioned on this site before. Here’s a comprehensive survey:
* One-handed tourniquets that soldiers can apply in seconds to wounded comrades
“Approximately 200,000 of these tourniquets have recently been ordered and shipped to theater,” says Colonel Robert Vandre from Army Medical Department (AMD). “It is starting to be used now and reports are coming in from our surgeons that they are receiving patients with these tourniquets on damaged limbs.“
* A pair of new bandage designs — one based on desiccants (like you find in the pockets of new coats) and another on crushed crustaceans — that encourage rapid clotting of wounds
Vandre again: “Since the beginning of the Afghanistan conflict, the Department of Defense has fielded two new bandaging technologies for stopping bleeding: the Chitosan Bandage, [made by] Hemcon, and QuickClot, [made by] Z-Medica. The Chitosan bandage is made of shrimp shells and sticks to the wounded area, sealing it off much like a tire patch. The QuickClot is made up of desiccant granules that physically adsorb the liquid from blood, thereby concentrating the clotting factors and encouraging rapid clotting to stop the bleeding.”

* A new medicine, developed by Defense Advanced Research Programs Agency (DARPA), that helps organs survive temporary blood shortages
“The focus in this program is using the consequences of blood loss,” says DARPA spokeswoman Jan Walker. “What we want to be able to do is protect the organs from the impact of oxygen loss and ensure that the wounded soldier can recover fully. What that allows us to do is it gives us more time to get the casualties to a hospital.“
* A sonic blood coagulator, another DARPA project
Walker: “We have another program that is looking at acoustic energy to stop bleeding — that is, deep bleeding, not in an extremity, not in some place where you can apply pressure. It’s called Deep Bleeder Acoustic Coagulation. It uses sound waves to encourage clotting. It’s a device that could be used by a layperson, a medic on the battlefield. It’s portable, light and automated.“
* Another clotting agent, Recombinant Activated Factor VII (RFVIIA), developed by AMD
“Through an extensive collaboration with the Israelis, we promoted the first use of RFVIIA in for the treatment of severe surgical bleeding in trauma patients,” Vandre says. “RFVIIA stops bleeding in trauma patients when their own clotting mechanisms are not working properly. As a result of this collaboration, RFVIIA is now being used in major trauma centers throughout the world and has been used on over 400 wounded patients in Iraq. Currently the drug’s maker, NovoNordisk, is pursuing clinical trials to gain a trauma indication for this drug with the Food and Drugs Administration (FDA).“
* New ways of freeze-drying replacement blood to facilitate transport and storage
“The Army is actively developing freeze-dried plasma and hopes to have a product available within five years,” Vandre says. “Plasma is the liquid part of blood which contains the majority of its clotting factors and is highly desirable for early resuscitation of patients. Currently it exists on the battlefield only as frozen plasma and, as such, cannot be given any place but at our field hospitals. DARPA and the Navy have both pursued freeze-dried platelets, another clotting product. The Army has also developed a process to allow red blood cells to be kept refrigerated for up to 12 weeks, which is twice as long as they currently can be stored. We are working now to get funding to push this product through advanced development and FDA certification.“
* A new container, developed by AMD, for transporting perishable replacement blood
Vandre: “To allow medics to bring blood products far forward on the battlefield, our researchers developed the ‘Golden Hour’ Blood Transport Container which can keep four bags of red cells at 10C for 72 hours with no electricity or wet ice. This container is being used in theater on evacuation missions where red blood cells may be of help to the wounded patients.“
The survival rate of troops injured in Iraq and Afghanistan is better than ever. Thanks to these technologies and others, even more soldiers will survive their injuries on future battlefields.

PTSD Sensors for Returning Troops

murdoc — Fri, 24 Feb 2006 13:35:34 +0000

The Pentagon wants to know how its soldiers are handling the transition from wartime to regular life. But getting them to see a counselor isn’t easy, even in the age of Oprah. So the Defense Department’s fringe science division is funding development of wireless sensors (scroll down) to tell whether a veteran is stressed or hitting the bottle too hard after coming home from deployment.
AFrame Digital and Barron Associates, both based in Virginia, are focusing on veterans recovering from battlefield injuries. They both are investigating a “low-cost, noninvasive ‘trip-wire’ system [that] required that functions as a safety net, detecting when assistance or intervention is needed and issuing advisories to health care providers concerning significant changes in important medical indicators.” These monitors will “collect and analyze real time data of vital signs, patient activity, fall acceleration and location parameters to detect deviations.” AFrame already makes a version for seniors, that picks up “pulse, temperature, and mobility” and comes with a “panic button and fall detection.“
Massachusetts’ Erallo Technologies is focusing on whether a vet falls down from drink or stress, instead. According to the Associated Press, one in eight returning troops has PTSD symptoms. CNN puts it at one in five. Its “Intelligent, Wireless, Agent-based Health Monitoring Network for PTSD and Alcohol” will include “a wireless transdermal alcohol sensor, heart rate monitor and accelerometer.“
Presumably, like AFrame, Erallo is expecting its system will incorporate “socially acceptable form factors, secure wireless networks, intelligent analysis software, displays for medical personnel, and interfaces to medical record systems.“
But those form factors better be pretty dammn small. Because if a soldier feels shy about paying a private visit to a therapist, how eager is he going to be to walk around with some clunky armband?