Proceedings PaperAutonomous hemorrhage monitoring
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Hemorrhage is the largest preventable cause of death in the battlefield, accounting for roughly half of all fatalities. Bleeding-control techniques have not improved substantially since the 1800s. Recent advances, such as quick-clotting bandages, are notable, but they do not address the basic problem of managing bleeding, especially internal bleeding in the battlefield with limited, if any, access to material and expertise resources. This paper introduces a novel approach in form of a wearable autonomous resuscitation system that interfaces non-invasively with the body to sense, analyze, and affect the hemodynamic response to bleeding. Trauma severity is quantified by detecting in the arterial pulse the acute physiological response to bleeding. A probabilistic risk assessment leads to a report on the countermeasures most likely to optimize the hemodynamic response to bleeding. The report is used by the effector to stimulate selected compensatory physiological mechanisms, such as "shifting", whereby the blood flow is redirected away from the hemorrhagic sites, "pooling" whereby the blood is pooled in vital areas (heart, brain), and "freezing", whereby blood loss is minimized by regional vasoconstriction. Stimulation is effected non-invasively by modulating the interoceptive system and therefore the autonomous nervous system. The paper describes several means of stimulating such reflex mechanisms by exploiting the physiological communication between the external and internal sensory systems to conclude that such a system could significantly enhance patient survivability and sustainability.