Sunday, June 10, 2012

Praxis: The Soldier Saver. "New abdominal aortic tourniquet, heading into war zones, has Birmingham roots."

A new kind of inflatable tourniquet created by Dr. John Croushorn and materials experts will soon be in the hands of U.S. Army combat medics. It was named by Popular Science as one of the top 10 inventions of the year. (Photo credit Birmingham News.)
This showed up in my local paper yesterday.
BIRMINGHAM, Alabama -- On Friday morning the U.S. Special Operations Command received its first shipment of a medical device that has Birmingham roots and promises to save lives on the battlefield.
The Abdominal Aortic Tourniquet will be used when soldiers or Marines are injured in the pelvis or upper leg by gunshot, shrapnel or a blast, causing a wound that could bleed a person to death within minutes. A medic quickly straps the AAT around the belly of the victim, tightens it with a windlass and pumps in air.
This pushes a balloon into the belly with the force of more than 80 pounds, clamping the abdominal aorta against the spine to cut off blood flow to the legs.
"The idea is you're turning off the faucet," said Dr. John Croushorn, one of the inventors. Croushorn is an emergency department doctor at Trinity Medical Center and a former U.S. Army surgeon, and his start-up company, Compression Works, is based in Hoover.
Four plastic parts of the one-pound AAT are made by Innovative Composite Solutions, a UAB spinoff co-founded by Uday Vaidya, a UAB professor of mechanical engineering. ICS develops and makes high-strength thermoplastic composite components, and it won $100,000 in the 2009 Alabama Launchpad business plan competition sponsored by the Alabama Economic Development Partnership Foundation.
The AAT "soldier saver" was picked as one of the top 10 inventions of the year in the June issue of Popular Science.
Compression Works will ship 500 of the AATs by the end of June, and the device is getting further testing by the Army, Navy and the United Kingdom at the U.S. Army's Institute of Surgical Research in San Antonio, Texas.
Croushorn filmed a training video in Hoover last month, using volunteers from metro-area police departments dressed as Army soldiers, with one wounded in the pelvic area and covered with Halloween-store fake blood. The video simulates a firefight, and Croushorn plays the Army medic who straps on the AAT and pumps it up in a minute and a half.
Capability gap
Military surgical interest is high, because the wounds called "pelvic-junctional hemorrhage" have been the number-one capability gap for the past five years. Terrorists seem to be aiming at that part of the body, which is unprotected by body armor.
In the 1800s Joseph Lister created, and briefly used, a large C-clamp device called the Lister tourniquet to press on the belly to stop blood flow during leg amputations.
U.S. military medics had been kneeling on the bellies of wounded men to mimic that clamping, Croushorn said. In 2006, a group of doctors at the Medical College of Georgia's emergency medical department decided to see how hard you had to push on the belly to stop the blood flow in the femoral artery of the leg.
The volunteers were the doctors themselves. They put a tightly bundled pad about the size of a human knee on the belly, and then put dumbbells on it, starting at 20 pounds and increasing the weight by 20-pound increments to 140 pounds.
Blood flow stopped at 80 pounds or above, with an average of 104 pounds of pressure.
Croushorn and co-inventor Dr. Richard Schwartz, head of emergency medicine at the Georgia Health Sciences University, heard the dumbbell study at an emergency physicians meeting in New Orleans, and talked about making a device to simulate the dumbbell pressure.
The first prototypes came in 2007, and the key step was a test on eight anesthetized pigs to see what happened if the prototype was left on for an hour, instead of just minutes for the human volunteers. This simulates the time needed to get the wounded soldier to a surgeon.
"We thought we were going to kill the pigs,'" Croushorn said, but the results were surprising -- no signs of dangerous changes in blood potassium or lactate levels, and no sign of damage to the small and large intestines.
Their final device got quick approval by the FDA last year, and a potential order for 10,000 to 30,000 units is in the works.
An even bigger market may be civilian EMS teams, Croushorn said. Dog experiments suggest that clamping the abdominal artery results in better chest compression results to push blood and oxygen to the brain. This could be vital for people who have suffered out-of-hospital cardiac arrests.


Anonymous said...

"Their final device got quick approval by the FDA last year, and a potential order for 10,000 to 30,000 units is in the works." unquote

note to self...file under:

"WTF 101??"
ummm, what part of "10k to 30k units" do they expect to use? This suggests someone up there has a plan..perhaps er..I dunno, maybe somptin like.. a "domestic" plan...?

And if not..WTF?? Do these people who order this stuff for the DOD really have more than one neuron between their ears?? Musta been the same people orderin 4mil rounds of ammo for DHS..I mean..I smell somethin.. like dead bodies pilin up forgot..they already ordered and received a Million or so body bags.. er, wait, I forgot..why the hell do they need all those new tourniquet thingys anyway?.. I mean everyone knows they have all them thar "precision" killin Drones with machinegun/missles and such..about 30-40k...over America..coming soon to your backyard BBQ!! Wow..what a party..just can stand within 5' of yo neighbor and ZAP!..he's gone..nothin you won't have a hair outta place..except maybe an enhanced sun tan. Wow...will wonders ever cease.. I love tech. These Drone thingys make a mockery of these touriquet thingys though, wouldn't ya think, huh? Hey, maybe we ought let that Fed gov "budget oversight" office in on this little contradiction. I hear they have a few more neurons than those dimwits over at that DOD purchasing office. After all, they just hung a few of their own by the balls for thowin a great big ole party for themselves to the tune of a few hundred grand. Breathtaking. Who'd thunk. Well
ya'all gotta scuze me now..I gotta go puke.

Pat H. said...

As an Operating Room Nurse, I find that interesting.

Unless there are negative side effects, not all organs can stand to have blood cut off for two hours, then it might have applications for surgery.

For example, knee replacements almost universally done with a tourniquet around the thigh. If this could safely reduce blood flow during hip replacements, that would dramatically improve outcomes from that procedure.

Old NFO said...

Good for them, and hopefully it WILL save lives in the field!

Anonymous said...

I gotta say, that absolutely rocks! Then they should ship it to any outfit running chainsaws. Even if it is applied wrong and is excruciating, you'd only have a few seconds of diversion before you blacked out!

Anonymous said...

To "WTF 101", you don't think that order of 10-30k would have something to do with the two wars we're currently fighting, or the potential of invading Iran? Use in theater and in training medics and possibly CLS to use these so they can, I don't know, stop abdominal bleeding?

Some of you guys have got to understand logistics. A 30k order is not unusual for an organization that employs OVER A MILLION people. If these will save lives, I don't care if they order a million of them. Better use of my tax dollars than the FCC.

Anonymous said...

To "WTF 101", you don't think that order of 10-30k would have something to do with the two wars we're currently fighting, or the potential of invading Iran? unquote

Two wars? Dumb me. I was under the impression we pulled out of least the "fighting" units. Although, unless there's some pretty intense liaisons of State Department personnel, I highly doubt the embassy will need these..of course, they might after Hillary personally reams the new ambassador for his little trysts.

But just to be fair, ok, I'll bite.
Quote:Better use of my tax dollars than the FCC."
That's a ROTFLMFAO if I've ever seen one. BETTER USE OF YOUR TAX DOLLARS?? How bout this Mr. Brilliant. They wouldn't have to spend your tax dollars on this item if they weren't ALREADY spending trillions of your tax dollars on supporting EMPIRE building in the first place..oh, did I mention these are illegal in the first place too. And don't give me that Congress approved the AUMF..crap. Congress usurped the Constitution PERIOD. And they passed it based on LIES. WMD lies. So put that in your "logistics" pipe and smoke it.
However, that has nothing to do with my comment, which it's blindingly obvious you DID ..something in the works? Right?? However, given our latest high tech, I highly doubt we'll engage in another Mideast debacle like Iraq/Afghanistan..I mean..after all, how many young people do we have that still believe in Empire?
That doesn't mean I don't understand these things could save some lives. I just cringe when I see things that imply our Gov may be doing the same thing they claim of those women, children or other civilians who happen to be near, or attending funerals of, "suspected militants" who were blown to smithereens via our Orwellian "precision assassination" machines"well, they're probably up to no good".

SPARE ME. Murder is murder. So when I see things like this article implies...well, me thinks our good ole Murderer in Chief is..well, "probably up to no good."

and btw, speaking of Orwellian logistics, I hear we're on the verge of a logistics know..bout 30 or 40 THOUSAND Drones are about to enter OUR airspace. Wow, talk about jobs. Logistics pro's are probably haven a prep party somewhere right now. Just think..fuel, parts, arsenal, personnel, maintenance,support and most of all..those cyber pilots ..hey..there's 30 or 40k jobs right there!!! ,...geeeze..I can almost hear the rejoicing right now..."HAPPY DAY'S.. ARE HERE AGAIN...."

Unfortunately, me thinks SOME people here ain't gonna be too thrilled about it. Logistics my ass.

Anonymous said...

Hey Mike, thanx for the info. wish I knew where I could purchase some of these things. Would like tro have a few for my unit. If you can find out, my e-mail is Thanx again. Have a blessed day. Paul III%

Anonymous said...

Well well well....I guess I wasn't too off target concerning the Cyber Pilot "jobs" thing.

Logistics won't be far behind either.

8 months ago, my son was on the beach, and saw a Predator drone flying 100' or so above the ocean off the coast of Oregon. He couldn't believe it. I hope people start taking videos of these. Maybe when enough people realize their little world is now in an Orwellian nightmare, they might start waking up. Of course, after speaking to a few people about it in my community, I doubt it. Talk about obtuse American concern. Most didn't even give a damn. Oh least they've got 'Merican Idol to fill the void. Talk about make me vomit.

Anonymous said...

The Abdominal Aortic Tourniquet becomes the first truncal tourniquet to save life in both upper and lower junctional hemorrhage

Birmingham, AL – June 27,2013 Compression Works LLC is excited to announce
that the Abdominal Aortic Tourniquet became the first truncal tourniquet to save
life in both upper and lower junctional hemorrhage earlier this month.

The Journal of Special Operations Medicine published a case report on a
casualty with lower junctional hemorrhage that survived after application of the
AAT in late Afghanistan earlier this year. This was published in the Summer 2013
edition and provides a detailed accounting of how the tourniquet saved the life of
soldier who was dying despite current best practice treatment.

On June 7th a civilian gun shot victim in Birmingham, AL in class IV hemorrhagic
shock survived a wound involving the left axillary region because of the AAT. The
injury destroyed 6 cm of the patient’s brachial artery. The AAT was applied to the
left axilla and secured around the opposite shoulder. IT controlled the
hemorrhage and the patient survived the injury.

The AAT is the only device able to displace enough soft tissue to stop blood flow
through the proximal subclavian artery from the axilla. The case report is pending
review for publication at this time. More information can be obtained on the
company’s website,

The AAT is the only device capable of stopping pelvic junctional bleeding as well
as upper torso junctional bleeding. This is a problem that accounts for close to
30% of deaths on the battlefield. Difficult to control hemorrhage in these areas
are also a problem in the civilian pre-hospital setting. Extremity tourniquets
cannot work because they cannot be applied above the point of wounding. New
hemostatic dressings do not work because of the large areas required to fill when
these dressings.

The Abdominal Aortic Tourniquet is available exclusively in the United States
from Speer Operational Technologies (www.speeroptech.som) and in the EU
from Fenton Pharmaceuticals Ltd in London, UK