Ultrasonic tourniquets could stop blood vessels from bleeding out by non-invasively coagulating blood using focused sound waves. (Credit: Philips Research)
The Pentagon is committing $51 million to creating a tool for acoustic cauterization.
The U.S. military has begun developing an ultrasonic tourniquet in an effort to stop life-threatening bleeding during combat.
Called the Deep Bleeder Acoustic Coagulation (DBAC) program, it aims to create a cuff-like device that wraps around a wounded limb. Rather than applying pressure to the wound to stem the flow of blood, the device would use focused beams of ultrasound (sound waves above the audible frequencies) to non-invasively clot vessels no matter how deep they are.
If a major blood vessel is hit and a lot of blood lost quickly, a person can die in a few minutes, says Michael Pashley, head of Ultrasound Imaging and Therapy at Philips Research in Briarcliff Manor, NY, one of the groups taking part in the program.
According to the Pentagon's Defense Advanced Research Projects Agency (DARPA), "these internal bleeding injuries are the leading cause of death for soldiers in the battlefield," says Pashley. In light of this, DARPA is committing up to $51 million for the project over four years, to be spread among a number of different research organizations.
The ultrasound tourniquet is intended to buy time, so that a medic can get the patient to a better-equipped medical facility, says Lawrence Crum, director of the Center for Industrial and Medical Ultrasound at the University of Washington's Applied Physics Laboratory in Seattle, who has been working in this field for more than a decade.
Once applied to a wounded limb, the cuff would automatically detect and then seal damaged blood vessels or arteries, by focusing beams of ultrasonic waves at the wound to clot it, in a process known as high-intensity focused ultrasound, or HIFU.
Ultrasonic waves are usually innocuous, bouncing off tissue. This is the principle behind sonograms, says Crum. But when the ultrasonic waves are focused, the effect is radically different. "If you concentrate ultrasound in the same way as light, you can raise the temperature, particularly if the wave is absorbed by the tissue," he says.
To achieve this effect, the frequency has to be geared to increase its absorption by the tissue, while the intensity must be roughly one million times greater than imaging ultrasound. When applied to a bleeding wound, the effect is similar to cauterization, Crum says.
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Guest (Richard)
If the army don't develop this idea, nobody will. This technology can bring many new possibilities in the future.
50 milion is less than the US government pays in interest everyday...
Guest (Kat)
Oh, Baby, this is medical Star Wars. This is not a new idea at all, and if it showed promise there is a little branch of the government called the NIH that is designed to fund suff like this. Hmmm, 50 mil would bankroll 100 scientists with some really inventive ideas, with $500K project grants. If this is a good idea, why does Phillips need money from the government to study it? And if this was a REALLY good idea, them smart venture capitalist dogs would already be funding it….
Guest (gerry)
Nope, this is a DARPA issue, not an NIH issue. Different foci, but the citizens will win in the end if it works. As pointed out earlier, if we're spending $50M that's really small potatoes to the Feds, even if it's make one of my projects go on, like, forever.
Since I've been in the trenches with cutting edge medical research (sorry, I just couldn't say "bleeding edge") I've a little bit of a feel for some of the things that show promise. I think this is one of 'em.
Guest (Rodrigo)
That way wounded soldiers could be detected really easy as ultrasonic sounds can be heard with special devices. Its just a thought ^o)
Guest (Salsa Shark)
Isn't this thing gonna hurt like hell. There has to be a les painful way to heal somone, like couldn't they just make like a hemoglobin shot or something.
I have to say it being the humanitarian I am, why ar ethey using it for war first anyway. This could be the difference between walking outside and stay couped up indoors to little hypocondriac children.
Guest (gerry)
So it hurts. We've got drugs to help with that. "Hurts" beats "dead" every time.
Guest (spankey)
So did the bullet and/or bomb that caused the need for the device in the first place. Geez you guys, this is a fantastic advancement in medicine if it works out.
Guest (Mike)
The "Golden Hour" becomes redundant
This is a fascinating project with real applications in the civilian world. Any paramedic will acknowledge that intra-thoracic or intra-abdominal haemorrhages result in a patient's death due to blood loss that cannot be controlled. Time to urgent surgical intervention is the only solution to stop the haemorrhage. A device described above really does promise the "Holy Grail" for paramedic practice for the future by being able to stop the clock on the "Golden Hour". Diagnostic ultrasound is already available for prehospital use in small hand-held devices. One should remember that the world's first "portable" defibrillator (developed in Northern Ireland in the early 1970's) weighed 90kg and had to be dragged around on a hand trolley. Now they are the size of a personal CD player and can be fully automatic.
Guest (Inyerface)
Howdy! Not on the defibrilator that came out of Ireland but the Medical Anti Shock Trouser. Covers the abdomen and legs. Pumped up with air causes internal pressure increase to collapse internal vessels. Incearces blood pressure centrally but does not replace surgery to stem blood loss either veinous loss or arterial loss. Also injurous when removed incorrectly or outside of surgery.
Guest (Mike)
Yes, I liked using the MAST and found it to be useful in a select number of patients. It was certainly not a solution to haemorrhage control though. It offered a temporary means of raising mean arterial pressure, but did so while effectively exacerbating blood loss from the internal site of injury. Not so good. Current evidence from medical research has now lead to its "fall from grace". So we certainly need something to control haemorrhage without the application of pneumatic counter-pressure. This program sounds very exciting indeed.
They are targeting this due to a large body of growing experience using hi frequency focused ultrasound energy (HFUS)-- the prime current use is in MRI guided destruction of tumors (including gynecologic fibroids). Energy can be stereotactic localized to melt tumors this here is logical next step. A noninvasive approach to vessel embolization. wwww.docinthemachine.com
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Guest (mark)
another way to do it
How about using microwaves to cauterise leaking blood vessels.
Using a real time imaging system with an electronically steerable microwave beam could conceiveably achieve whole of body cauterisation. Surely all of the work on hi-tech radars and medical imaging could make this possible. Not just for the military but for civilian use as well. thanks.
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Guest (mARK)
not easy
microwave generators are much larger and more power hungry. not something a medic can have a bunch of in his pack.
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Guest (gman)
Microwaves will not work, but this project is probably still an enormous misuse of taxpayer money
Ultrasound is a far superior choice for focusing in the body and converting acoustic energy to heat and/or causing damage by mechanical means. However, the ability to first find bleeding and then reliably cauterize the vessel has never been demonstrated in an extremely controlled setting, much less a battlefield. In fact results have been quite variable. At the moment this is a lot of money being tossed at a very speculative project…there are much more promising techniques that better deserve this money.
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Guest (jhuan)
That's right
Support the above suspect.
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Guest (maumas)
the more money you spend, the more money you can steal
thats how it works
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Guest (dogbert)
Magic Pill
It would be a better idea to give out magic pills that instantly diagnose and treat in the field without the need of any medical training whatsoever, and could be developed for a mere 49 million. They will be lighter, the end of the study will yield similar results, and the government saves 2 mil.
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Guest (gerry)
re: another way to do it
But, the idea isn't to truly cauterize and disrupt function of the vessel. With HIFU the vessel walls generally will remain viable. With microwave RF cautery, they won't.
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