Automatic Detection of Internal Bleeding in Air Ambulances

A new system being tested on medical helicopters in the Boston area has been shown to help detect serious cases of internal hemorrhaging that would otherwise be only detected later in the hospital. The system consists of nothing more than a typical patient monitor that tracks the heart and respiratory rates along with blood pressure, and a connected computer that processes the data.

The system is called APPRAISE (Automated Processing of the Physiological Registry for Assessment of Injury Severity), and is being tested by the Massachusetts General Hospital (MGH) in partnership with two other trauma centers, as well as the U.S. Army and Boston MedFlight, the air ambulance service.

In the current study, more than 200 patients taken by helicopter were screened using the system, though their care was not affected. It was able to identify about 80% of those with life threatening internal bleeding, though the rescue team spotted only about 50%.

The researchers also passed patient data gathered in 2005 by a Houston helicopter team through the APPRAISE algorithm to further refine its capabilities.

“The fact that decisions to proceed with surgery or to replenish lost blood often occur only after patients’ arrival means there are delays – sometimes brief but sometimes prolonged – in initiating such life-saving interventions,” said Andrew Reisner, MD, MGH Department of Emergency Medicine and senior author of the study, in a statement. “We are now working on a follow-up study to use this system in actual trauma care and will be measuring whether it truly leads to faster treatment of life-threatening hemorrhage and better patient outcomes. This approach could also be helpful for patients transported by ground ambulance and for hospitalized patients at risk of unexpected hemorrhage, such as during recovery from major surgery.”

Study in journal Shock: Automated Analysis of Vital Signs to Identify Patients With Substantial Bleeding Before Hospital Arrival: A Feasibility Study…

Source: MGH…