DOD’s medical innovations save lives, speed rehab
- By Mark Pomerleau
- May 20, 2015
Despite the official conclusion of America’s longest war at the end of 2014, American troops are still deployed in hostile environments all over the world. Ensuring soldiers’ safety is a top priority of the Defense Department both on and off the battlefield, so researchers have been hard at work testing and deploying the latest technological solutions for health, safety, response and rehabilitation.
For immediate assessment in battlefield conditions, Army researchers showcased one of their latest developments in triage at the Defense Department’s recent Lab Day. The Compensatory Reserve Index, or CRI is a small device -- roughly the size of a matchbox -- with a computer display. When placed on an injured soldier’s finger , the device displaying and wirelessly transmits vital signs, such as body temperature, heart rate, breathing rate and blood pressure, according to an Army statement.
The severity of injuries sustained are not always readily apparent, so the CRI is especially helpful in that it reads multiple vital signs almost immediately, letting medics prioritize triage care.
"One of the challenges now with triage is that with multiple casualties on the battlefield, the medic may have a difficult time determining which patients need to be treated first," said Lt. Col. Robert Carter with the Army Institute of Surgical Research. “With the CRI, the medic can quickly snap the device onto everyone who is down, and the vital signs are almost immediately displayed.”
Medics are also equipped with tablets that receive the CRI data and display the vital signs of several individuals on the same screen, which helps them monitor more than one injured soldier at one time.
But the “machine-learning algorithm” was lauded by Carter as the “most important aspect of CRI.” The algorithm is designed to extract a patient’s vital signs using “’a material waveform-based photoplethysmography,’ which is the medical way of saying that it uses a non-invasive, optical method of detecting blood volume changes in the microvascular tissue,” the Army said.
The CRI is also currently being tested by the Food and Drug Administration for certification. Then the Army will determine whether or not to field it, Carter said. Meanwhile, multiple civilian trauma care centers and clinics around the country are testing and using the device, as the Army has decided to share its technology.
The Army has also made strides in enabling communications in austere locations, so that medics at combat support hospitals can use pagers or cell phones to consult with staff at a medical facility in the event of a life threatening incident. The voice-activated digital paging system allows hands-free communications throughout the hospital.
Off the battlefield, researchers have developed effective methods for treating soldiers with Post Traumatic Stress Disorder using Virtual Reality Exposure Therapy, which has been a staple at Landstuhl Regional Medical Center in Germany for soldiers returning from war to civilian life. Approaching PTSD treatment through virtual reality has allowed soldiers relive traumatic experiences so as to help them process and cope with the experience going forward.
"It's an extremely effective treatment because it is a patient's personalized reality that they learn to process, control and regulate," said Dr. Michael Valdovinos, chief of outpatient behavioral health at Landstuhl Regional Medical Center. "Visual memory is powerful, and if I can use that to help patients create their own movie scene, then they can move into it to rewrite their own script."
During the virtual exercises, doctors immerse patients in real-life scenarios in an attempt to replicate battlefield experiences as accurately as possible. The repetition of seeing traumatic events decreases symptoms of anxiety and fear, which allows patients to navigate recreated virtual environments and eventually come to terms with their experience in a non-stressful, medically supervised environment.
On the rehabilitation front, scientists with the Veterans Affairs Department have turned to robotics to reduce recovery time for those with spinal cord injuries. The Functional Electrical Stimulation Hand Glove 200 is a robotic hand that combines active functional electrical stimulation with passive robotic bio-mechanic movement. It encourages faster muscle and strength recovery , thus reducing overall rehabilitation time.
First-round trial data suggested that the FES Hand Glove 200 “improved hand function, particularly fine motor skills, dexterity and speed, decreased swelling, improved range of motion and hand strength,” the VA said, resulting in improved quality of life for those with tetraplegia. A second round of trials will focus on the device’s benefits for those with polytrauma.
Mark Pomerleau is a former editorial fellow with GCN and Defense Systems.