Prolonged field care requires medical engineering innovation

Prolonged field care can mean the consideration of what might kill, not just what is killing you, right now, as it is trauma medicine. There are other considerations in prolonged field care, but sepsis and infection are near the forefront. Because of those concerns, we’ve developed tools and techniques that streamline our trauma care efficiently, but not necessarily to sit on a patient for an prolonged period of time. We’re trained to do an amputation in an austere environment, but we don’t re-train, and we don’t discuss it much at the unit. We get bogged on clinical medicine, seeing patients, making sure everyone’s shots are up to date. We’ll help with pediatric medicine and make sure our immediate life-saving procedural skills are ready to be employed.

Trauma is not a skill set SOF Medics can let slide. Yet as we move along into immature theatres, there’s a myriad of things that can kill you. Without innovative medical engineering solutions SOF medics might be forced to rack their brains like MacGyver to keep someone alive.

One thing we always take for granted in a robust trauma theatre and especially here in the states – is infection. We know when most patients are headed to the operating room they’re going to receive a healthy bolus of strong antibiotics. This is a good thing. But in the future we might not have the ability to medevac our patients within the golden hour. It could be 72 hours to a week and longer. There’s no telling how long it could be for our partner forces. All of Special Operations will move into lowered footprint post wartime and more towards austere work, in the shadows. This will mean the responsibility on the SOF medic is that much greater than it has been in the past, because there might not be an alternative.

We also need innovative ways to sterilize wounds and create sterile environments. A sterile environment in the event of an emergent surgical procedure without the guarantee of a hospital recovery.

Expedient surgery in a bubble

A sterile bubble, when compressed small enough to fit in truck, accompanied with enough CO2 to the fill the bubble walls to provide structure. The interior would be sterilized, collapsed and packaged for deployment and ready for re-inflation. It would need to be the size of a standard bedroom, 10 feet by 10 feet.  This could deployed in less than 60 seconds. Then a team could bring in sterilized equipment while ensuring that the patient is prepared for surgery. The patient could then enter the Mobile Surgical Advanced Operating Room (MSOAR) ready for the surgical procedure.

The Borgen Project noted that surgery in a bubble would be advantageous but could have some drawbacks. Short of an alternative, this would well in an austere environment in a secured area. For example, this could be useful if a sandstorm eliminates an air medevac option in Southeast Syria in the future, if we have a more pronounced ground presence there. Engineers without borders are already thinking about this. On the Borgen Project website,

A bubble sterile isolator is discussed in Berry & Kohn’s Operating Room Technique, by Nancymarie Phillips. In fact, we’ve already seen the idea displayed in science fiction. Here is a shot of the med-pod seen in Ridley Scott’s science fiction film, “Prometheus.”

This is one possibility out of many, but war zones and war zone trauma are not on the decline, but our overt military presence is and, in turn, medical innovations and engineering are bound to flourish and fill a need.

Featured image courtesy of prolongedfieldcare.org.