Las Vegas Sun

March 29, 2024

Overcoming the shock and awe disasters

Research on how to better treat mass casualties in war and disasters - with machines that can be operated in the field to reduce the shock that follows traumatic injury - is being conducted by a local technology firm and surgeons at the University of Nevada School of Medicine.

Together, they are examining a portable and efficient way of heating blood and other fluids to help stabilize patients before transport to hospitals. The warmed fluids are crucial in treating shock.

Rocky Research, a Boulder City-based company specializing in heating and cooling devices, has developed a thermal battery-powered heating device to do just that, and has asked University Medical Center Trauma physicians to put the blood warmer to the test.

The research, funded with a $2.1 million grant from the Department of Defense, is being conducted by medical school surgeons Tom Shires and John Fildes and Rocky Research. Consulting them is Anthony Serfustini, a combat-tested Navy surgeon who retired in Las Vegas.

Serfustini said the device is crucial to reducing mortality rates on the battlefront, in mass casualty attacks or in natural disasters. He brings first-hand knowledge of the problem to the project.

Serfustini was on the front lines in Iraq in the spring of 2003, trying to ignore artillery fire while preparing wounded Marines for evacuation to Kuwait. The biggest challenge was warming blood and saline solution fast enough to resuscitate patients and keep them from going into shock or hypothermia.

Blood typically needs to be stored at 34 degrees Fahrenheit, but must be pumped into the patient at body temperature - 98.6 degrees or higher.

That's tough to do without a consistent power source.

"If you start giving cold fluids to a person who is already cold you are going to send them down a slippery slope," Serfustini said.

The best appliances currently available - Thermal Angels - are single-patient, non-reusable devices that are not able to heat blood quick enough in a mass casualty situation, Serfustini said.

Shires and Fildes, who are specialists in fluid treatment, are helping to fine tune the Rocky device so it can consistently deliver fluid at the right temperature and flow.

Shires is world renowned for developing the saline drip during the Vietnam War. Now considered a crucial part of patient care, saline solutions pump healing fluid into the body's organs. He also helped develop a formula to determine the fluid needs of burn patients immediately after injury.

As director of the University Medical Center Trauma Center, Fildes works with local emergency responders to improve the initial treatment patients receive while en route to a hospital.

The thermal battery is crucial in saving lives, Fildes said - especially in the event of a terrorist attack or disaster leading to mass casualties. It allows doctors to treat patients at the scene, by warming blood or saline solution with battery-powered devices when there is no other power available, while they are waiting for transport to area hospitals.

The four-pound device heats blood as it travels through tubing from the IV bag to the patient. A similar process is used in hospitals, but the high-tech battery allows the process to occur where there are no other power supplies.

The battery can be recharged using electricity or any source of available heat, including solar power or a camp fire. Unlike lithium batteries, it also does not lose its charge in storage.

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