Body armor for soldiers in the U.S. Army is an effective lifesaver, but everything has its kryptonite. For body armor, the weakness is not the device itself but its length limitation.
Insurgents often aim below a soldier's body armor where the trunk meets the legs, trying to hit some of the body's largest blood vessels. This causes soldiers to bleed to death within minutes because compressing the injury is difficult if not impossible.
Two emergency physicians who served in the Army took note of this problem, and pondered a device that could restore the “golden hour” so soldiers could survive long enough to get care.
“I was a physician in the Army, and spent the majority of my career working for the Special Forces unit, and one thing medics have talked about over the years is slowing bleeding in lower extremities by kneeling over the abdomen to compress the aorta,” said Richard Schwartz, MD, the chairman of emergency medicine at the Medical College of Georgia, a part of Georgia Health Sciences University.
“It got me thinking that we could probably create a device that could externally cross-clamp the aorta and control hemorrhaging in the lower extremities effectively on the battlefield, and that's where we got started with the idea,” he said.
Dr. Schwartz, and John Croushorn, MD, the chairman of emergency medicine at Trinity Medical Center in Birmingham, AL, created an inflatable wedge-shaped bladder that acts as an abdominal aortic tourniquet. Dr. Schwartz was a member of the 5th Special Forces Group (Airborne) during Operation Desert Shield and Desert Storm. Dr. Croushorn served as Command Surgeon, Task Force 185 Aviation in the U.S. Army in Iraq in 2004.
“The device itself is very simple,” Dr. Schwartz said. “It looks like a fanny pack, and is made so it is put around the casualty's abdomen. It has a buckle that you snap like a fanny pack, and you cinch it down with a strap.
“You want to get it as tight as you can before you inflate, and there is a windlass that tightens it down like a tourniquet,” he said. “After you get it very tight, it has a rhomboidal-shaped bladder inside that inflates toward the abdomen. You place the device over the belly button, and as it inflates, the bladder creates pressure directly over the aorta.”
This device has obvious applications on the battlefield, but it also may have other uses for stateside emergency medicine. “I think back to when I was a resident doing my trauma rotations in Oakland,” Dr. Schwartz said. “I had gunshot wounds in the abdomen and pelvis that would have benefitted from this type of device. There is a great deal of difficulty getting control of bleeding no matter the setting.”
The device also may have applicability for CPR, but this theory needs testing. “If you look at what this device does, it really isolates your blood flow from your upper and lower extremities, and in theory this could be a device that could be beneficial in CPR,” Dr. Schwartz said. “If you could stop profusing your lower extremities when you're doing CPR, in theory you would greatly increase the profusion of your vital organs with each compression if you didn't have to profuse your lower extremities.”
Primarily, though, this remains a battlefield lifesaver, and the duo has received orders for the device from the U.S. military. They also will teach military and law enforcement officers how to use it. The device's development was funded by the U.S. Department of Defense.
© 2012 Lippincott Williams & Wilkins, Inc.