NOVEMBER 26, 2014
Fight for life ... Australian and Afghan troops race to evacuate the civilian victims of a Taliban roadside bomb in Oruzgan Province. A new combination of drugs to be administered in the first 10 minutes after sustaining serious injuries such as gunshots is intended to put victims into “hibernation”. Source: Defence Source: News Limited
WHEN a soldier gets shot, time is a killer: As the blood flows, the heart and brain starts to shut down. But a new battlefield treatment seeks to reprogram the body’s response — and save lives.
It’s the first 10 minutes after being shot that count most, says Dr Geoffrey Dobson of Queensland’s James Cook University.
Shock overwhelms the body. The heart can stop as blood-pressure levels fall below the minimum needed to sustain the vital organs.
But new techniques being investigated to kick-start the heart after cardiac surgery may evolve into a “hibernation” treatment to help save lives in the dusty fields of Afghanistan and Iraq.
Along with Research Associate Hayley Letson, Dr Dobson and the Division of Tropical Health and Medicine have received $550,000 from US Special Operations Command to fast track their new emergency treatment.
“During the fighting in Iraq and Afghanistan, more than 87 per cent of all deaths among allied soldiers occurred in the first 30 minutes, before they could get to a hospital,” Dr Dobson says. “Nearly a quarter of these, almost a thousand people, were classified as having potentially survivable wounds. Time was the killer.”
But US — and Australian — special forces teams will soon have new hope if wounded far behind enemy lines.
“The idea of our research is to save that thousand lives,” Dr Dobson says.
Rapid reaction ... Keeping soldiers alive long enough for help to arrive is the goal of a fast-tracked James Cook University program. Source: Defence Source: Supplied
“Our treatment cancels out the shock and puts them in a low-blood pressure, hibernation-like state. You want to dial-in the right blood pressure to prevent further blood loss but high enough to keep the major organs, including the brain, going.”
The new emergency drug treatment is delivered in two stages, directing about 100 mils of medication into the veins or blood marrow. This reduces the need for immediate hefty blood transfusions which can shock the body a second time.
Shot one is intended to kickstart the heart in the critical first few minutes after a severe wounded.
Shot two is aimed at reprogramming the soldier’s metabolism into hibernation mode, buying enough time to allow an emergency evacuation.
“You want to stabilise the system because of the long retrieval times in forward areas for these special operations soldiers,” Dr Dobson says. “We increase the blood pressure to a low ‘optimal’ level sufficient for survival, we reduce inflammation and we correct the blood coagulation — stop it getting thinner.”
The low — but sufficient — blood pressure also helps protect the brain if it has been injured.
The initial studies have shown great promise, he says, prompting the US military to seek to fast-track it to the battlefield.
Dr Dobson says, given the program’s success, it will also likely appear in rural and remote paramedic services which have to stabilise injured before transport to distant urban medical centres.
The funding aims to have the drugs ready for human trials within a year.
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