Device Developers ‘Kicked a Hornet’s Nest’ in Hemorrhage and Shock Treatment

By Stephen Spotswood

Air Force Col Todd E. Rasmussen, MD , director, U.S. Combat Casualty Care Research Program (CCCRP), speaks about medical lessons learned from the wars in Iraq and Afghanistan, during the Medical Museum Science Café, held May 24, 2016, at the National Museum of Health and Medicine (NMHM) in Silver Spring, MD. National Museum of Health and Medicine photo by Matthew Breitbart

BETHESDA, MD — For Air Force Col. Todd Rasmussen, MD, and Jonathan Eliason, MD, the idea for a new way to treat internal hemorrhaging on the battlefield was hard-won.

It arrived after being exposed time and again to servicemembers bleeding out from internal pelvic and torso injuries at forward operating bases. They saw firsthand how deadly traumatic hemorrhage, the number one cause of combat deaths for U.S. servicemembers, could be. And it was during the gaps between deployments when they realized that solution might exist in technology already commonly used in civilian hospitals. 

Rasmussen, now a professor of surgery at the Uniformed Services University and deputy director of the U.S. Combat Casualty Care Research Program at Fort Detrick, did his vascular surgery training at the Mayo Clinic through the Air Force’s Health Professions Scholarship Program. He began what he refers to as a “revolving door of deployments” in late 2004. Over the next several years he would complete tours as a surgeon at Balad Air Base, Iraq (2004, 2008), Bagram Air Base, Afghanistan (2010, 2012), and at the Afghan National Army Hospital in Kabul (2006).

It was at Balad in 2006 that he and Eliason, who is now at the University of Michigan, would first have the idea for what would eventually become REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta).

“What we observed downrange as the major problem for mortality was bleeding,” Rasmussen explained. “While we had good solutions for extremity hemorrhage, we did not have good options for torso hemorrhage. If there’s an injury to the spleen and it’s hemorrhaging and the patient has 20 to 40 minutes to live, you can’t put a tourniquet on the spleen.”

Their training as vascular surgeons allowed them to see not just the frustrating nature of the problem but possible solutions based on existing vascular technology.

“We had never trained as trauma surgeons,” Rasmussen explained. “Because of that, we had a little bit different viewpoint of vascular control. There’s been a real revolution in how we treat vascular disease—moving from open operations to endovascular devices like stents, balloons, and stent graphs. We would see these new technologies being applied to age-related vascular disease. Then we would see all this bleeding when we were deployed—injury followed by subsequent hemorrhage and shock.”

1 2 3 4

Comments (1)

Trackback URL | Comments RSS Feed

  1. john barwise says:

    This is a great technology that had a primitive predecessor called a “MAST” suit which was not very successful because it could not do what this device does. It tamponades the internal hemorrhage giving time to repair the problem. Great work well done.

Share Your Thoughts