628
P.-Y. S. Hsueh et al.
be treated differently from typical overpressure injuries, hence needing a granular
understanding of the relationship between the blast components and neurological
injury. However, existing practice of medical personnel relies on visual signs and
personal accounts of patients to alert them about the possibility of TBI.
In this case study, we introduce the DARPA Blast Gauge project, which aims
to identify a quantitative means for measuring blast-related exposure and in turn
provide a screening tool for medical personnel to better identify soldiers at risk for
TBI. The Blast Gauge collects quantitative data along with the screening tool in
order to uncover the mechanisms of TBI.
During the course of pilot testing over 2 years, the Blast Gauge has been used
to check on soldiers who suffered shrapnel injuries (visible wounds) but did not
report blast exposures to the medical personnel. By design, the Blast Gauge is a
wristwatch-sized, self-contained system that continuously measures the amount of
blast exposure a soldier has been exposed to. The color of the light (red, green,
yellow) on the gauges display signals the level of exposure occurred during the
engagement. Following the light indicator, different treatments would be prescribed
according to the standard protocol. For example, if the light is yellow, which
indicates moderate exposure, the medical personnel would download the data from
the Gauge to evaluate the risk for TBI. If a mild TBI is detected, then follow-up
treatment for TBI will begin immediately.
The pilot testing study consisted of two phases. The first phase of the pilot
involved approximately 900 soldiers of an Army brigade in their active combat
roles. The second phase of the pilot study deployed the Gauge to more than 10,000
soldiers in a variety of units across the military. The monitoring data collected by
the Gauge not only provide accurate information collected by the Gauge are used
for medical personnel to understand what their patients actually experienced during
an exposure. This capability enables actionable insights being generated for in-field
decision-making for medics and doctors and embedding such actionable insights
directly in the care flow that provides immediate triaging to injured soldiers. For
example, DARPA was using the data compiled from these devices to understand
blast propagation, provide new insights into sources and causes of traumatic
brain injury, and ultimately develop technologies that help minimize exposure and
improve medical care.
The continuous measurements and visible signs for person-level in-field
decision-making, but also provide a quantitative basis to enable policy-level
decision-making and develop a long-term TBI diagnostic solution for the battlefield.
This is especially important to the Army, in which soldiers are used to the mentality
of not seeking medical aid for the “invisible” injuries, such as TBI. The Gauge
not only stop at the diagnosis of the TBI risk, but also helps ensure the triage –
even in the cases in which soldiers might downplay their own symptoms to avoid
being taken out of fight. The positive results of the pilot study have led to the
encouragement of the House Armed Services Committee in its 2013 National
Defense Authorization Act Report [105].
P.-Y. S. Hsueh et al.
be treated differently from typical overpressure injuries, hence needing a granular
understanding of the relationship between the blast components and neurological
injury. However, existing practice of medical personnel relies on visual signs and
personal accounts of patients to alert them about the possibility of TBI.
In this case study, we introduce the DARPA Blast Gauge project, which aims
to identify a quantitative means for measuring blast-related exposure and in turn
provide a screening tool for medical personnel to better identify soldiers at risk for
TBI. The Blast Gauge collects quantitative data along with the screening tool in
order to uncover the mechanisms of TBI.
During the course of pilot testing over 2 years, the Blast Gauge has been used
to check on soldiers who suffered shrapnel injuries (visible wounds) but did not
report blast exposures to the medical personnel. By design, the Blast Gauge is a
wristwatch-sized, self-contained system that continuously measures the amount of
blast exposure a soldier has been exposed to. The color of the light (red, green,
yellow) on the gauges display signals the level of exposure occurred during the
engagement. Following the light indicator, different treatments would be prescribed
according to the standard protocol. For example, if the light is yellow, which
indicates moderate exposure, the medical personnel would download the data from
the Gauge to evaluate the risk for TBI. If a mild TBI is detected, then follow-up
treatment for TBI will begin immediately.
The pilot testing study consisted of two phases. The first phase of the pilot
involved approximately 900 soldiers of an Army brigade in their active combat
roles. The second phase of the pilot study deployed the Gauge to more than 10,000
soldiers in a variety of units across the military. The monitoring data collected by
the Gauge not only provide accurate information collected by the Gauge are used
for medical personnel to understand what their patients actually experienced during
an exposure. This capability enables actionable insights being generated for in-field
decision-making for medics and doctors and embedding such actionable insights
directly in the care flow that provides immediate triaging to injured soldiers. For
example, DARPA was using the data compiled from these devices to understand
blast propagation, provide new insights into sources and causes of traumatic
brain injury, and ultimately develop technologies that help minimize exposure and
improve medical care.
The continuous measurements and visible signs for person-level in-field
decision-making, but also provide a quantitative basis to enable policy-level
decision-making and develop a long-term TBI diagnostic solution for the battlefield.
This is especially important to the Army, in which soldiers are used to the mentality
of not seeking medical aid for the “invisible” injuries, such as TBI. The Gauge
not only stop at the diagnosis of the TBI risk, but also helps ensure the triage –
even in the cases in which soldiers might downplay their own symptoms to avoid
being taken out of fight. The positive results of the pilot study have led to the
encouragement of the House Armed Services Committee in its 2013 National
Defense Authorization Act Report [105].