Innovations in Battlefield Medicine

Military medicine by nature is expected to be delivered regardless of poor infrastructure, bad terrain, inclement weather or lack of trained personnel. Frost & Sullivan has identified a few interesting innovations that are either designed specifically for use on or near a combat zone, or would be well-suited for such use.

According to the U.S. Department of Defense (DoD), nearly 15% of the country’s active-duty forces, or about 200,000 troops, are stationed overseas in 177 countries—each with a distinct culture, infrastructure, and access to emergency services. A large portion of these troops are part of peacekeeping missions or are serving in combat zones, such as in Afghanistan and Iraq. Even those who serve in what are considered relatively safe capacities, such as in embassies or consulates, can be exposed to sudden and unexpected violence, as was witnessed during the attack on the U.S. mission in Benghazi, Libya, in 2012.

While all governments strive to provide their troops with the best medical help possible, exceptional circumstances often complicate the task. Military medicine by nature is expected to be delivered regardless of poor infrastructure, bad terrain, inclement weather or lack of trained personnel. Frost & Sullivan has identified a few interesting innovations that are either designed specifically for use on or near a combat zone, or would be well-suited for such use. 

Eyes-On by Evena Medical (Roseville, Calif.)

One of the key challenges of infusion nursing and anesthesiology is obtaining intravenous (IV) access. Surveys of registered nurses, IV nurses, physicians, and medical staff at community, urban, rural, and university-associated hospitals revealed success rates between 40 and 60%; in other words, on average only about half of all IV procedures performed by medical staff are successful on the first attempt. Success rates are further complicated by a patient’s age, skin color, obesity, physical condition, and willingness to cooperate, and above all by the pressure that the professional is under. Many of these factors are compounded in a combat area. 

Eyes-On is Evena’s wearable point-of-care imaging system. It is the first-of-its kind device for real-time vascular imaging that employs multi-spectral imaging for visualization of the vein network below the skin. In essence, the Eyes-On acts like a mixed-reality visualizer, allowing a provider to see the skin as it is through the glasses’ clear lens while also viewing the vasculature beneath the skin as processed by spectral cameras built into the glasses’ frame.

Golden Hour Ambulatory Rescue Park by U.S. DoD Combat Feeding Directorate (Natick, Mass.)

Named after the crucial period of time after a battlefield injury in which appropriate medical attention has to be given, this portable medical kit is designed to keep medical supplies handy and appropriately stored.

The Golden Hour Ambulatory Rescue Park (HARP) has a storage volume of 2 liters—sufficient to hold and transport water, IV fluids, drugs and other perishables—and a compartment to store ancillary dry goods. The kit’s cooling is powered by a single flexible solar panel that also charges the on-board battery so that the cooling system can be powered at night.

The Golden HARP boasts active temperature monitoring and control, integrated diagnostics, and displays of temperature and battery-life status. Kit designers kept in mind Army backpack regulations and the weight that a soldier has to carry throughout the day. The Golden HARP is especially valuable in Iraq, where summer temperatures can easily exceed 110 degrees Fahrenheit, or on scouting missions to remote locations.

Implantable Biosensors by Profusa, Inc. (San Francisco, Calif.)

In 2016, Profusa announced that it had received a $12 million grant from the Defense Advanced Research Projects Agency (DARPA) to develop implantable biosensors that can continuously monitor various physiological parameters. The need for continuous monitoring is well appreciated. In fact, Profusa’s first product, the Lumee Oxygen Sensing System, is a dissolved oxygen detector used to study peripheral artery disease. The sensor system is now commercially available in Europe.

The challenge this time is to develop a multi-parameter sensor system that can measure diverse metrics such as oxygen level, urea content, blood glucose and lactate levels and transmit that data wirelessly for continuous, remote patient monitoring.

Artificial Blood by the Matrix Biology and Engineering Lab at the University of Virginia (Charlottesville, Va.)

Hemorrhaging from extremity wounds is a major cause of battlefield deaths. While artificial platelets can cause blood to clot, the clot formation pattern is too random to stop bleeding from wounds.

Thomas Barker, director of the Matrix Biology and Engineering Lab, has designed platelet-like particles (PLP) that migrate to the wound site and initiate the clotting process. The PLPs are made of soft gels that have small fragments of antibodies attached to them. These antibodies selectively attach to fibrin, the principal clotting factor in the body, rather than fibrinogen, a biomolecule associated with pre-clotting. Hence, the antibody-laden PLPs home toward the injury site as soon as the body’s natural clotting process begins to augment its efficacy. Using this as a platform, the scientific team hopes to develop PLPs that can be injected into a soldier prior to battle to promote clotting and clot contraction, and into wounded patients to prevent excessive bleeding.

The Road Ahead

As unfortunate as war is, the necessities and unique challenges of military medicine have benefitted the civilian community, just as the demands of space exploration have yielded several commonly used products. The need for portable imagers during World War I directly led to ambulatory radiology systems. Giant strides in wound care and antibiotics can also be directly attributed to developments for the battlefield.

Frost & Sullivan predicts that emerging technologies such as brain-computer interfaces, robotic exoskeletons and neuroprosthetics will be blessed by the patronage of the military community before finding wider acceptance in society.

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