Abstract - Kenneth G. Proctor, Ph.D.
Kenneth G. Proctor, Ph.D.
New vital signs, a wireless monitoring device, and ...
In helicopter transports, we showed that pre-hospital heart rate variability (HRV) triages better than routine trauma criteria or enroute vital signs. In hospitalized TBI patients, we showed that HRV correlated with changes in head CTs. We also devised a versatile algorithm which incorporated HRV with other vital signs and further improved specificity and accuracy for triage. However, it may be impractical, if not impossible, to measure HRV in many conditions, so we are presently evaluating other non-invasive monitoring techniques in patients. In context with work from other investigators, this suggests that triage decisions could be improved by algorithms derived from non-invasively measured variables or other vital signs.
A Wireless Vital Signs Monitor (WVSM) has been developed by the Office of Naval Research (ONR) and the United States Army Institute of Surgical Research (USAISR). It incorporates different, albeit conceptually similar, HRV-based algorithms implemented far out to the point of injury and adds complete trend analysis over four hours. This WVSM is too bulky for field operations by US Special Forces (SOCOM), but functional prototypes of an alternative miniature wireless monitoring system with improved trend analysis even further out to the point of injury have now been delivered Mini-medicTM ( www.athenagtx.com).
The primary objective of this project is to perform the first field tests of the SOCOM Mini-medic. Lessons learned from our previous and ongoing trials will be applied. Data will be shared with USAISR and ONR, to explore a secondary objective: develop new algorithms derived from vital signs to predict life-saving interventions.
We have a unique perspective on combat casualty care because all Army Forward Surgical Teams train at University of Miami. This collaboration between a university, USAISR, ONR, and industry partners could lead to other novel monitoring or therapeutic strategies that could directly benefit military or civilian trauma victims.
This project is totally driven by the technological needs of the SOCOM, rather than by a classical hypothesis. Basically, a miniature monitoring system has been developed for far forward use to capture whatever useful biological information is possible from small sensors placed on the forehead or extremity of up to 5 casualties, then wirelessly transmit to cell phone sized monitors carried by any first responder within a range of 100 meters. The need is to triage, prioritize transport and to track changes in numerous casualties from a remote location. Within that context, an overall working hypothesis can be stated as follows: changes in multiple parameters or derived variables monitored from a severely injured patient correlate favorably with conventional vital signs monitors either before or after definitive treatment at a level 1 trauma center.