ANAHEIM, Calif. -- By their vary nature, DARPA-funded medical devices are a grim, gruesome bunch. They tend to focus on keeping troops alive until they can be evacuated, which also gives such programs a dose of heroism. These are gadgets that run the entire spectrum of treatment, from keeping patients breathing and staunching gushing wounds to helping amputees lead a more normal life. Attention is paid to potential civilian applications, but with casualties continuing to mount in both Iraq and Afghanistan, there's a sense of urgency to these programs--we need them, and right now.
Unfortunately, most of what's on display at DARPATech is still years away from final-phase development. And even if a completed program is considered a success, there's no guarantee anything will be deployed. That said, here are some of the most promising medical devices being presented at the conference, along with their potential impact in the current ongoing conflicts.
We've already covered the bases on this program--a self-contained suite of robots that would allow for remote emergency surgery. Since the Trauma Pod's goal is to stabilize the patient as quickly as possible, it's a perfect fit for Iraq, where severely wounded IED victims can bleed out during an airlift to a field hospital. The robots in the Trauma Pod will try to keep the patient's airway clear, stop any life-threatening bleeding, and take CT scans for diagnosis, using a combination of autonomous operation, surgical tools and remote guidance from a human surgeon.
Short-Term Impact: The earliest estimate puts the Trauma Pod in full production in 2011, but more likely 2013 or later. In terms of our current engagements, that's a political lifetime away. An experimental prototype might see use in 2009, but that doesn't necessarily mean it will be tested in Iraq or Afghanistan.
Deep Bleeder Acoustic Coagulation (DBAC)
This powered cuff will wrap around a patient's limb, and use ultrasound to both diagnose and treat the injury. This is a very specific device, designed to autonomously find and seal so-called "bleeders." Low-intensity ultrasound scans for injured vessels by imaging the blood flow. When it finds what appears to be a serious interruption, it hones in on that area, and creates a 3D model of the severed vessel. Then, things get spooky: The system hits the vessel with high-intensity focused ultrasound, triggering coagulation within 30 seconds. The DBAC device will do everything autonomously, from diagnostics to targeted hemostasis.
However, the DBAC program is still in its first phase, with some interesting data and results, but no actual blood-coagulating device to show for them. The team has yet to test it on blood, for example, and the mockup on display at the conference was more of a conceptual prop.
Short-Term Impact: The earliest possible DBAC deployment would happen in 2010, with the Army most likely receiving production models first, followed by the Marines. That timeline might land the device in Iraq and Afghanistan, where it could definitely save lives. But considering how much testing still has to be done, DBAC might have to wait for the next war.
Revolutionizing Prosthetics (RP)
DARPA's four-year program to create advanced, highly-functional prosthetic arms already seems like a success story. Researchers at Johns Hopkins have already created Proto 1, which provides force feedback to the user, meaning that test subjects were able to actually feel when objects were in their prosthetic hands. Proto 1 also enables more natural walking, since it can swing freely, instead of locking in place like a standard prosthesis, which can drag the user to one side, upsetting balance and leading to serious back injuries.
Proto 2, which is undergoing testing now, is a major step up, with seemingly unprecedented freedom of movement (at least 15 degrees in the arm, and up to seven in the hand) and fingertips packed with 24 sensory elements. Proto 2 can transmit the sensation of heat, for example, to electrodes on the subject's shoulder, producing a kind of perceived hot spot on the skin. It's not a direct feed to the cortex, but considering the brain's incredibly elastic ability to rewire perception and even cognition, Proto 2's sensors could--with a little practice--function much like biological ones.
The drawbacks are weight and power. While DARPA simply wants the final arm or arms to be comfortable, the Hopkins team has self assigned a target weight of 7 pounds--and the full-arm Proto 2 currently stands at 9.5 pounds. This is a major hurdle, since the team's goal is to create an arm that's used as often as a native one--if it's too heavy, the user might only wear it for specific situations. Proto 2 also has to stay connected to a small computer, and a battery pack, adding more weight, and requiring a beltpack to be worn at all times. And the battery is proving problematic. DARPA's requirements are for 18 hours per charge, but the Proto 2 team thinks they'll make it to eight. But the program has another two years to go, and with a little help from the entire battery-obsessed electronics industry, that number could go up.
Another hurdle--and DARPA requirement--is propioception, or the ability to sense where your limbs are when your eyes are closed. For now, amputees have to keep a careful watch on their arm while controlling it, with only a limited ability to grab something in their peripheral vision. It's a huge challenge, but the researchers seem confident that they can pull of at least some level of proprioception by 2009.
Short-Term Impact: The Revolutionizing Prosthetics program has already changed the lives of its amputee testers. And even if Proto 2 were released as is, it could have a huge impact on troops wounded in Iraq and Afghanistan. Whether those conflicts are still underway when the program wraps in 2009, amputees can upgrade to better prosthetics whenever they become available. Price could complicate things, especially if insurance providers balk at what's likely to be an expensive piece of technology. But these arms are already genuine prosthetic breakthroughs, with potential benefits for hundreds of veterans.
Simplified Automated Ventilator (SAVe)
This slimmed-down, straightforward ventilator is smaller and lighter than a standard automated model, weighing just 3.1 pounds (compared to 13 to 14 pounds). It's operated with a single knob, which turns the SAVe on, and allows you to mutes the low-battery alert, turn off the LED lights, or shut both functions off (presumably for stealth operations). The device runs for 3.5 to 6 hours per charge, or it can be plugged in.
The point of this thing is to free up a medic's hands in "far-forward theatre" situations. That's jargon for the frontlines, essentially, where combat medics would never be able to haul around a massive, complex auto-ventilator. The current solution is to use an Ambu-bag, a big plastic bulb connected to a breathing mask, which the medic or patient manually pumps. It's a relatively imprecise tool, especially when bullets are cracking overhead, and suddenly you're squeezing irregularly or simply way too fast. SAVe provides even, measured breaths through a mask, ET tube or other patient connection. SAVe's makers aren't sure whether it will be stored in far-forward vehicles or in a medic's kit, or a combination of both, but here's the good news: It's ready right now.
SAVe is in the final stages of FDA approval for military use. Once its cleared, production will begin immediately, and its makers will move on to a larger, more complex version, designed for both military and civilian use. A prototype for that model should be ready in September, with a run at FDA approval happening next year. The point of the follow-up model is to allow for more ventilation options, such as adjusting pressures, volume and rate. It will have preset modes that first responders can use, such as Small, Medium and Large (for the patient's size), and a manual mode to let skilled personnel fine-tune its operation.
Short-Term Impact: It remains to be seen whether the larger version will make it through testing and approval, especially considering its potential civilian use. But the kit-portable SAVe could be in the field in a matter of months.