(Rapid Emergency Actuating Tamponade) - a new system for controlling bleeding from a knife wound.
A short video about the project.
A short video about the project.
Designed for manufacture.
Tested and developed.
Prototyped and analysed.
REACT - A life saving opportunity.
What it does
The REACT system uses a rapid, inflatable Tamponade device that is inserted into the stab wound. The automated inflation of this Tamponade provides internal pressure direct to the bleeding site, controlling bleeding faster than current methods.
In the year ending March 2019, 259 people were killed using a sharp instrument. In most cases the recorded cause of death is blood loss. It takes 10 minutes for an ambulance to arrive in London, but it only takes 5 minutes to bleed to death. The Police are often the first trained responders at the scene, but they do not have the rapid and accessible tools required to prevent blood loss. The advice for treating stab wounds is to never remove the impaled object. This is because the object is applying internal pressure to the wound site whilst also filling the cavity, preventing internal bleeding. REACT is based on the same principle.
How it works
The implantable medical-grade silicon Balloon Tamponade is inserted into the wound tract by a first responder. The actuator device is connected to the Tamponade valve, and the user selects the wound location with the rear OLED UI. Squeezing the trigger on the actuator starts the automated inflation sequence, and the Tamponade is inflated to a defined pressure based on the wound location (150-180mmHg). Pressure sensors within the Actuator are used as a feedback loop, measuring and ensuring the desired pressure inside of the Tamponade. LED arrays on the sides of the Actuator provide the user with visual information feedback, while the torches at the front of the device can be used as spotlights in dark environments. Safety features have been engineered into the Tamponade valve, including an excessive pressure blow-off valve and an emergency pressure release. The Tamponade has been designed to be MRI safe and completely aligns to the pre-emergency care workflow.
Conducting desk-based searches into stab wound topology and the current understanding for wound management, I then spoke to Paramedics and Emergency First Aid professionals to understand the protocols and processes for managing bleeding. I presented these stakeholders with several concepts and the Inflatable Tamponade was selected for a rapid development phase. The Balloon Prototype has seen 13 rounds of iteration. An electro-mechanical test rig was designed and built to test the balloon’s capacity to hold the required pressure. Physical properties like shape and wall thickness, as well as material properties like stiffness and Shore hardness have been continuously tuned to find an appropriate material and design. The Tamponade valve has also seen 7 rounds of development. 3D printing has been used to develop and validate the valve seal and pressure release mechanism, concluding in a fully functional seal. For the Actuator, development toward an alpha prototype has involved the design and manufacture of 2 prototypes, an initial handling model and then a resolved, functional prototype. The design of imbedded electronics and mechanical systems has allowed the functioning prototype to be physically tested (within Covid restrictions) and validated virtually by end users.
How it is different
Wound management techniques like wound packing have started to be used by paramedics globally to prevent bleeding. This process involves tightly “stuffing” a wound with gauze, applying pressure internally to the site. The process is slow, technical and extremely painful to the patient, but has been proved to stop bleeding from knife wounds quickly. This technique is not suitable for wounds in cavities like the abdomen (most common for knife attacks). It is also very challenging to remove gauze from the wound during reconstructive surgery, which can cause clinical complications. The simple application and automated inflation procedure of the REACT system makes it a game changer for first responders. The Tamponade can be in place and stopping haemorrhage in under a minute, saving hundreds of lives a year. The tamponade is suitable for large cavities like the abdomen, and it is also easy to remove, giving the patient the best chance in reconstructive surgery.
The decision was made following the advice of project stakeholders to apply for Intellectual Property protection for the REACT system. A UK Patent application has been filed which covers the many innovative aspects of the design. The commercial potential of the REACT system is exciting, and this patent protection will allow continued development into the product. Medical device development takes a long time, but hopefully in a few years the REACT system will be used to control the bleeding in victims of knife crime and save lives. Patent application number: 2105238.6
Overall Winner of the 2021 Loughborough Enterprise Award for Design. Shotlisted for the 2021 New Designers Breakthrough Design Award. Invited to exhibit in the New Designers E-Zone. Invited to exhibit at the forthcoming Art and Design Exhibition at Tsinghua University, Beijing.