Without prompt care, a badly wounded soldier can easily bleed to death while being transported to a distant medical station. Two traditional treatments — tourniquets and medicated gauze pads — often cannot stop the blood loss from a deep wound at the neck, shoulder or groin.
To give these soldiers a fighting chance at survival, undergraduates at Johns Hopkins University, in Baltimore, supervised by two surgeons at All Children's Hospital, in St. Petersburg, have invented an injectable foam system designed to stop profuse bleeding from a wound where a limb or the head is connected to the torso.
The students' invention is designed to apply pressure and curb blood loss during the critical first hour when a wounded soldier is moved to a site that provides more advanced medical help.
The new battlefield treatment is needed, the students say, because a tourniquet or a gauze pad with a clotting agent are difficult to apply effectively to deep wounds at these junctional body sites. In addition, the precise source of blood loss in such wounds is not always easy to find.
“The problem is that damage from bullets and bone fragments deep inside a junctional wound is not always visible from outside the body, and a regular clotting agent may not be able to reach the origin of the bleeding,” said Sydney Rooney, leader of the biomedical engineering student team that sought to solve this problem. “We came up with a foam injection system that fills the wound area and blocks the blood loss.”
Rooney, of Elm Grove, Wisconsin, said the goal is to prevent wounded soldiers from losing more than half of their blood volume before they reach a medical facility. The aim is to reach such a facility within 60 minutes, the so-called golden hour during which trauma care is most successful.
“Our project has been dealing very literally with a life-and-death matter,” she said. “At the end of the day, that provided some extra motivation for our team.”
Last fall, Rooney and seven other Johns Hopkins undergrads chose to develop this battlefield blood-loss prevention system from a list of possible class projects. Their prototype emerged from the Johns Hopkins undergraduate design team program in the Department of Biomedical Engineering, which is shared by the university's School of Medicine and its Whiting School of Engineering.
All Children's Hospital surgeons Paul D. Danielson and Nicole Chandler proposed and supervised the Hopkins students' project. All Children's, a Johns Hopkins Medicine facility, is a clinical training site for medics in the Green Berets, Navy Seals, Army Rangers and Marine Special Forces who require pediatric emergency response experience. This allowed the student inventors to meet with these teams and the surgeons to discuss the project and prototypes.
Danielson, a military veteran who is now medical director for pediatric surgery at All Children's, said the students' device looks quite promising, even though it's still at the prototype stage.
“I don't think it's pie in the sky at all,” he said. “I think it's a very viable solution to a problem that's been plaguing us on the battlefield.”
Pediatric surgeon Chandler was impressed by the undergrads' solid grasp of design and clinical issues.
“I think the students did a wonderful job on this project,” she said. “Their understanding of some medical concepts was beyond that of many medical students. They came up with a simple, intuitive design that has the potential to save many lives.”
The students have received university approval to begin animal testing of the prototype system, but have not yet begun such procedures. No human testing has taken place. The students plan to work with their faculty advisers and medical sponsors to determine how to move the project toward further testing, and eventual adoption and use in military settings.
Robert H. Allen, an associate research professor of biomedical engineering at Johns Hopkins, directs the undergraduate design team program.