|
|
Care and maintenance of battlefield casualties after initial stabilization, after definitive care, and while awaiting and during evacuation is complex and difficult in the haze and chaos of the battlefield and during evacuation in land and air vehicles.
Vital signs are difficult to obtain reliably and patients may drift into irreversible distress before interventions can be applied or recognized as needed. Portable, lightweight, self-contained systems that provides capability for continuous monitoring of casualty status, including early markers of deterioration; for automatic alarming, and for closed-loop, automatic control of life support equipment and interventions would be of value to medical personnel after casualty stabilization and during evacuation.
The C3E portfolio includes research and development of diagnostic and therapeutic medical devices and associated algorithms, decision support tools and automated technologies for the critical care environment .
Conduct basic and applied research to support develop, validation, and use of technology (Hardware, Software, Systems, Algorithms, and Advanced Computational Models) to help primary care providers do his/her job in combat
The C3E portfolio includes research and development of diagnostic and therapeutic medical devices and associated algorithms, decision support tools and automated technologies for the critical care environment . Underlying the research is the premise that care providers need information on what they need to do, not just data from monitors which provide point in time measurement of vital statistics.
Recognizing there is increased risk with each step, we are moving from providing raw Data (heart rate 85, blood pressure 90/60) through Information (85% likelihood of needing a Life Saving Intervention) and Decision Support ( give 2 units of plasma) to Automated Care. Work underway includes:
The Burn Decision Support System (BRDSS), developed to assist clinicians when performing a burn resuscitation. The BRDSS gives infusion recommendations based on urine output measurements and provides a graphical fluid balance display during initial resuscitation. Within this area is a Clinical BRDSS for use in the burn ICU. It requires burn expert supervision and is tied to an electronic chart. The Mobile BRDSS is a medical tablet system for use in the field by non burn providers. Both are intended to lower the rate of complications due to over/under resuscitation, reduce the rate of abdominal compartment syndrome in military casualties and reduce mortality rates due to burn shock.
Similar products under develop will provide decision support algorithms for use in the critical care environment in the areas of ARDS/ventilation, nutrition, sepsis, and blood pressure management/pressor control. These will all contribute to reduction in provider variability, better patient outcomes, reduced rates of mortality/morbidity, and improved patient management.
The WoundFlow system captures and tracks wounds in burn victims.
The WoundFlow System captures and tracks wounds in burn victims with data quickly accessed by clinicians and provides a platform for data mining wound characteristics and heal rates. It automates wound mapping on critical care patients resulting in more accurate wound capture rates (better treatment implications)
The IDEA system will provide real-time bed-side analysis of existing and future vital signs with interoperability between medical devices. This hardware and software solution for acquisition and distribution of medical data will enable real-time analysis of patient medical data, reduce risk of patient infection by allowing remote monitoring, provide continuous data capture for retrospective research, use a standard communication protocol for medical equipment, and enable open/closed loop decision support systems.
Research in real-time medical metrics will bring current vital signs research to the bedside through development of new vital sign visualization techniques for patient care. This will allow for better usage of data from existing physiological signals through novel processing and visualization and improve response times for earlier interventions.
Research in real-time medical metrics will bring current vital signs research to the bedside through development of new vital sign visualization techniques for patient care. This will allow for better usage of data from existing physiological signals through novel processing and visualization and improve response times for earlier interventions.
Real-time system for predicting the need for Life-Saving Interventions (LSI) This will be a real-time system that can be deployed to battlefield care facilities or within the hospital and can predict instantaneously and continuously the need for and the appropriate LSI to be performed given a patient’s vital sign measurements. This will serve as an alternative decision support to the human-dependent (physician’s) assessment and evaluation of trauma patients in the field or within the hospital with the goal of reducing morbidity and possibly mortality in trauma patients.
The Smart Alarm Notification System is designed to be an algorithm framework composed of smart daemons that provide real time diagnosis and alerting of changes to critical care patients. Components include:
Such real time notification to providers on changes to patient status allows providers to respond faster to deteriorating patient conditions and provides more accurate data on patient status.
There are ongoing efforts in control of ventilation for combat casualties. The first is to develop an algorithm for closed-loop control of minute ventilation based on End-tidal carbon dioxide (EtCO2). That algorithm would then be used to test the safety and efficacy of an extracorporeal lung support device for treatment of Acute lung Injury (ALI) in far forward medical facilities. Software to control respiratory rate and tidal volume in an open/closed loop fashion would result in automation of ventilation, reduce ventilator-induced lung injury due to over-ventilation and improve blood flow to the brain in patients who suffer traumatic brain injury (TBI) by improving ventilation. The end goal is to reduce morbidity and possibly mortality in severe trauma casualties with requirements for mechanical ventilation.
The IDEA system will provide real-time bed-side analysis of existing and future vital signs with interoperability between medical devices.
Continue to move the efforts listed above through the developmental stages necessary to attain FDA approval. Concurrently, conduct research and foster development to expand knowledge and develop new algorithms, devices, and procedures that advance the decision-making capabilities of medical personnel, promote earlier intervention in intensive care combat casualty management and implement reliable automated controls wherever feasible.
ARMY MEDICINE | MRMC | HEALTH.MIL | BAMC | COMMUNITY COVENANT | JOINT BASE SAN ANTONIO |
| Privacy & Security Notice | External Links Disclaimer | Web Accessibility Disclaimer: Web Site Medical Information Posting Restrictions This Web site provides an introduction to the U.S. Army Institute of Surgical Research. It is intended for members of the public, news media, academia and Army beneficiaries. |
REPORT SUSPICIOUS ACTIVITY |