October 26, 2021
In early September 2021, the Defense Health Agency published a story highlighting a number of the advancements military medicine has made since the September 11, 2001 attacks. Many of the advances highlighted were supported in part by HJF. Read the article below to find out how HJF supported these critical military medical innovations.
Stop the Bleed
From the article: In life-threatening emergencies, minutes can make the difference between life and death. Bleeding control techniques, such as tourniquet application and packing open wounds with clean gauze – which were once primarily reserved for the battlefield – are now being widely taught to the public through the Stop the Bleed campaign, which trains Americans on how to respond to bleeding emergencies.
Early bleeding control is important both off and on the battlefield. Hemorrhage secondary to traumatic injury is the leading cause of death of Americans between the ages of 1 and 46. The Stop the Bleed campaign was launched in 2015 by the White House's National Security Council Staff. Since then, bleeding control has become widely taught and bleeding control kits are now commonplace in schools, airports, workplaces, and other locations.
Stop the Bleed was launched in 2015 with the support of HJF through the Combat Casualty Care Research Program. Since its inception, Stop the Bleed has come under the purview of the National Center for Disaster Medicine and Public Health, a research program at the Uniformed Services University of the Health Sciences that is administered by HJF. HJF has also licensed a video on how to properly use tourniquets for use by companies like FedEx.
From the article: Military research into bleeding control continues to be a priority, and lessons learned on the battlefield are being carried over to the home front. For example, the resuscitative endovascular balloon occlusion of the aorta (REBOA) device to stop hemorrhaging received approval in 2015 from the U.S. Food and Drug Administration.
The device was designed by Air Force Col. (Dr.) Todd Rasmussen and Dr. Jonathan Eliason, who served tours at the military's level III surgical hospital in Balad, Iraq and saw a need for a device that could stop blood loss in the pelvic area and abdomen. The ER-REBOA is not only being used by the military, but also in more than 250 hospitals internationally, and has greatly increased patient survival rates.
HJF supported the improvement of the ER-REBOA device with USU and PryTime Medical by facilitating research, filing for approvals, and coordinating FDA approval. For more information on how HJF supported the improvements to the first ER-REBOA device and helped get the device into critical care settings, watch the video below.
Osseointegration — Advances in Prosthetics
From the article: Advances in artificial limb technology since 9/11 have enabled warfighters who lost an arm, a leg or the use of multiple extremities, in Iraq or Afghanistan to function better. On December 7, 2015, two amputees who were Iraq and Afghanistan veterans, Bryant Jacobs and Ed Salau, became the first Americans to get a percutaneous osseointegrated prosthesis, or POP implant, through a clinical trial funded through the Department of Veterans Affairs.
While traditional prostheses involve placing the residual limb into a cup-like shell called a socket – which can cause pain, discomfort, and infection – the POP implants are surgically anchored into the patient's remaining thigh bone to allow connection to the prosthesis. Patients report a number of benefits including improved mobility, improved comfort, a decreased risk of falls, and a more "part of me" experience compared to socket prostheses.
In 2020, FDA approved the Osseoanchored Prostheses for the Rehabilitation of Amputees Implant System, the first implant system approved specifically for adults who have above-the-knee amputations.
HJF supported the largest and only OPRA device trial in the US for Transfemoral (above knee) amputees. The device was previously approved in Europe and HJF helped prepare the FDA approval application. HJF is also supporting the FDA study for the OPRA device to treat Transhumeral (above elbow) amputees. The team at USU-WR Department of Surgery, including many HJF staff, has conducted more Osseointegration surgeries than anywhere else in the U.S., including the only procedures for bilateral and triple amputees.
Val G. Hemming Simulation Center at the Uniformed Services University of the Health Sciences
From the article: Recent wars have demonstrated the need for more training and practice in life-saving procedures on the battlefield. The practice of using simulation for training military medical personnel dates back to the 1960s. In 1999, the Val G. Hemming Simulation Center at USU in Bethesda, Maryland, was created through the vision of the dean of the School of Medicine, Dr. Val Hemming. The center uses live actor simulation, mannequins, task trainers, and virtual reality to help train medical students, graduate-level nursing students, and Graduate Medical Education trainees.
The center is one of the largest and most comprehensive simulation centers in the Military Health System (MHS). In 2005, the Army established the Medical Simulation Training Center (MSTC) program with the goal of building and standardizing the skills of Army combat medics. However, the MSTC did not include physician and nurse training. In turn, the MHS initiated the establishment of hospital and school-based simulation centers to enhance clinical training and experience among doctors and nurses.
HJF administers the Val G. Hemming Simulation Center (Sim Center) program through several cooperative agreements with USU. HJF employs 20 teammates at the Sim Center whose work ranges from designing and coding virtual battlefield scenarios to managing military medicine education research. HJF also employs over 90 “standardized patients” that support the clinical skills development of USU medical students by role playing and enacting scenarios at the Sim Center.
From the article: Uncontrolled bleeding is the leading cause of preventable death on the battlefield. Increased use of tourniquets and hemostatic dressings, which clot the blood inside the wound, have saved the lives of many seriously wounded service members.
Soon after the attacks of Sep. 11, 2001, the Defense Department launched a series of studies to identify the most effective technology. Quikclot Combat Gauze has been used by the U.S. military in operations in Afghanistan, Iraq, and Syria. This type of bandage uses a compound found in the exoskeletons of shrimp and lobsters that helps form blood clots.
HJF supported the transfer of early generation QuikClot technology from the lab to the battlefield, enabling product development to bring the technology to market. Read more about the Fastclot® technology at https://www.hjf.org/case-studies/fastclotr.
MHS Centers of Excellence
From the article: Military Health System Centers of Excellence, or CoEs, were established to help the Department of Defense to speed the advancement of our scientific knowledge and evidence-based practices for diagnosis and treatment of diseases and conditions that impact our military personnel and their families with the help of a critical mass of experts.
HJF currently supports half of the MHS COEs listed in the article through research administration, program management and scientific resource staffing: