A “human-proof pointy-end”: a robotically applied hemostatic clamp for care-under-fire

A “human-proof pointy-end”: a robotically applied hemostatic clamp for care-under-fire

Can J Surg 2019;62(6):E13-E15 | PDF

Ian A. McKee; Jessica L. McKee, MSc; Brian E. Knudsen; Ryan Shelton; Tony LaPorta, MD; Juan Wachs, PhD; Andrew W. Kirkpatrick, MD, MHSc

Summary

Providing the earliest hemorrhage control is now recognized as a shared responsibility of all members of society, including both the lay public and professionals, consistent with the Stop the Bleed campaign. However, providing early hemorrhage control in a hostile environment, such as the scene of a mass shooting, is extremely challenging. In such settings, the first access to a bleeding victim may be robotic. An all-purpose bomb robot was thus retrofitted with a commercial, off-the-shelf wound clamp and successfully applied to an extremity exsanguination simulator as a demonstration of remote robotic hemorrhage control. As this method can potentially control extremity hemorrhage, further development of the techniques, equipment and, most importantly, the guidelines and rules of engagement should continue. We suggest that in order to minimize the loss of life during an active shooter incident, the armamentarium of prehospital medical resources may be extended to include law-enforcement robots.


Accepted Apr. 17, 2019

Affiliations: From the City of Edmonton, Fire Rescue, Edmonton, AB (McKee); the Tele-Mentored Ultrasound Supported Medical Interventions (TMUSMI) Research Group Collaborators (add city) (McKee, LaPorta, Wachs, Kirkpatrick); the Regional Trauma Services Foothills Medical Centre, Calgary, AB (McKee, Kirkpatrick); the Canadian Forces Health Services (add city) (McKee); the Arapahoe County Sheriff’s Office, Denver, Colorado, USA (Knudsen); the Denver South Medic Fire Rescue, Denver, Colorado (Shelton); the Rocky Vista University, Rocky Vista, Colorado (LaPorta); the James Purdue University, West Lafayette, Indiana (Wachs); the Department of Surgery, University of Calgary, Calgary, AB (Kirkpatrick); and the Department of Critical Care Medicine, University of Calgary, Calgary, AB (Kirkpatrick).

Funding: This work was partially supported by a Near Earth Space Technologies Grant from the University of Calgary and the Office of the Assistant Secretary of Defense for Health Affairs under Award No. W81XWH-18-1-0769. Innovative Trauma Care is the manufacturer of the iTClamp. They provided the iTClamps for the study.

Disclosure: The opinions, interpretations, conclusions and recommendations are those of the authors only and are not specifically endorsed by the Department of Defense of the United States of America or the Department of National Defense of Canada, or any other public or governmental agencies.

Competing interests: I. McKee, J. McKee and A. Kirkpatrick declare consulting fees from Innovative Trauma Care, outside the submitted work. A. Kirkpatrick also declares consulting fees from Acelity Inc. No other authors declare competing interests.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.002619

Correspondence to: A.W. Kirkpatrick, EG23 Foothills Medical Centre, 1403 29 St NW, Calgary AB T2N 2T9, Andrew.kirkpatrick@albertahealthservices.ca