Battlefield Medicine – Medical Device Advancements Continue to Come From the Killing Fields

If there is such a thing as a positive outcome of war, it is the advancement of medicine and medical devices. Historically, we have learned much in the areas of surgery, trauma, orthopedics, and wound management as a result of wars.

Some of the innovations that emerged during the Civil War include the development of field hospitals, the discovery of the link between immediate treatment and survival rates, and establishment of the connection between sanitation and infection prevention. World War I brought recognition of psychological damage resulting from war, along with the first blood banks and common use of blood transfusions. During World War II field doctors implemented widespread use of penicillin in wound care, and advances in orthopedic devices and procedures were significant. And, who would have thought of the helicopter as a medical device? The Korean and Vietnam wars brought air ambulance services into use, decreasing mortality due to war wounds, an application that has had a great impact in civilian emergency medicine.

Recent wars in the Persian Gulf, Afghanistan, and Iraq have brought advancements in orthopedics, trauma transport and surgery, and wound management. There have been – and continue to be – significant improvements in prosthetics and surgical instrumentation. As military and civilian doctors from previous conflicts say, “Medical innovations are born in days rather than in years.”

Developments from Current Conflicts

To treat extensive wounds on the front lines, innovative mobile units have been developed, and smaller, lighter medical devices of all types for these mobile units are undergoing continual modification and improvement. During Desert Storm I & II, for example, Integrated Medical Systems, Inc., developed Life Support for Trauma and Transport, an integrated system of devices in a portable intensive care unit. It includes a defibrillator, ventilator, and patient-monitoring subsystems. With history as our guide, we can expect to see these new devices in civilian use in the future.

Novel bandages have been developed to stop even severe bleeding almost instantaneously. One, the Hem-Con bandage, is made from an extract of shrimp cells. It was developed by a retired U.S. Army colonel, Dr. Bill Weismann, with military trauma use in mind. Also, devices facilitating the vacuum-sealing of open wounds have been perfected to minimize the amount of “work to get by” before patient transport. While the focus until now has been on meeting military needs, it’s easy to see how innovative wound care products will eventually enhance emergency trauma treatment in among the civilian population.

High volumes of orthopedic injuries have stimulated rapid development of devices such as the Disc-O-Tech. Inventors Lewis Pell, Motti Beyar and Oren Globerman saw a need for expandable implants for traumatic injuries requiring minimally invasive orthopedic surgery in recent conflicts in Israel.

With higher survival rates, particularly after roadside bombings, comes a greater need for artificial limbs. Today’s soldiers expect better prosthetics than those currently available. There has been increased activity in the development of lighter, more flexible prosthetic hands and arms; and these are expected to be military and civilian markets within four years.

Trauma Care Improves

Traumatic injuries are the leading cause of death for Americans under the age of 45, making the strides in knowledge and procedures during the most recent wars particularly relevant. The caseloads in today’s field hospitals, where the development of diagnostic and therapeutic methods and devices is accelerated, exceed the busiest American trauma units. In this environment, practitioners quickly gain extensive experience and can effect rapid improvements. For example, physicians in Afghanistan and Iraq have advanced the practical knowledge of sternal intraosseous devices, which are the most novel and effective method of fluid administration for trauma situations.

Highly efficient transport systems have been extremely important for improving injured soldiers’ survival rates. Technological advancements ensure that the injured are not only transferred more quickly, but are also receive better monitoring and treatment during transport. Improvements in medical transportation have carried over to the civilian world: the Air Force applied battlefield transportation lessons during the evacuation after Hurricane Katrina.

Further Improvements in the Future

New medical devices will continue to emerge from the battlefield, from wound dressings to improved prostheses. Civilian emergency responders can expect to see innovations such as laptop-sized diagnostic equipment, dehydrated blood products for longer-term storage and improved transportability, and a host of new medical devices.

The National Institutes of Health (NIH) and the U.S. Department of Defense invest in significant research and development to translate battlefield innovations into medical devices and procedures that save the lives of civilians and soldiers worldwide.