A lengthy but most interesting article. And it’s not only for military injuries but has come to play a vital role in civilian injuries as well. Firefighters and EMT have many of these new technologies available to them that were developed on the battlefield.
A major part is how quickly one can get from the injury site to a fully-staffed medical facility. But, there are also advances that are used in the field.
A variety of developing technologies will improve resuscitative care at the front lines. New tools may allow medics working near the point of injury to autonomously establish entry inside the large arteries and veins of the torso. Linked to small catheters that can work inside the vessels, these tools could allow medics to stop bleeding, restore blood volume, and control the circulatory system. New endovascular devices (that is, devices operating inside vessels) could also be coupled with automated drug and fluid delivery tools to provide pain control, anesthesia, and organ support. While this network of technologies is complex, all the elements exist in some form today. The remaining challenges are to miniaturize and integrate them, make them battery-powered, and test them in the lab and in field conditions.
Wearable biosensors and advanced vital signs monitors, which could serve the dual purpose of remotely locating and triaging injured troops, are also on the horizon. Collecting and analyzing large amounts of real-time patient data (a.k.a. predictive analytics) from these monitors could help inform and build automated devices such as ventilators, organ support machines, and infusion pumps. Decision support and automated devices would expand the medic or corpsman’s ability to provide golden hour care to a greater number of injured at any one time.
In situations where MEDEVAC and other life-saving measures are not available, telemedicine will also expand the capability of point-of-injury providers to perform some types of surgeries such as wound debridement, extremity fasciotomy, or amputation. Subsequent prolonged field care delivered by medics and corpsmen could then include treatment of large wounds, intra-abdominal injuries, and mangled extremities — injuries managed inside of a hospital operating room today. Although the science is less advanced in these areas, the military is investing in research on antimicrobial dressing systems and self-expanding foams able to be injected into the abdomen to stabilize bleeding and contamination until definitive surgery can occur.
Managing traumatic brain injury during the new golden hour will be challenging. In addition to more comprehensive study of new and wearable blast gauge technologies and improved protection measures to avoid blast exposure, research is focusing on devices to diagnose concussive traumatic brain injury and limit severe brain injury. Brain-wave and eye-tracking devices and rapid blood tests may soon be available to diagnose concussions on the battlefield. Innovations such as small devices that use light sources and software algorithms to look inside the skull to diagnose bleeding and then drill a hole to evacuate blood and relieve pressure could help treat more severe forms of traumatic brain injury.
Unmanned technology could also enable a new golden hour paradigm. Drones or unmanned ground vehicles could preposition — or deliver in real time — supplies for different tactical situations, a strategy already employed for humanitarian aid in Africa. Additionally, the military is researching whether and how unmanned MEDEVAC might augment patient evacuation. By creating teams of combat developers, medics, scientists and engineers to work on these initiatives, the military is trying to make sure that new technologies are not merely “cool,” but that they are actually necessary and will be effective in the golden hour of future wars.
A whole lot more @ How Long Can the U.S. Military’s Golden Hour Last?
