LSTAT: Global Applications of Portable Intensive Care

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LSTAT Global Applications of Portable Intensive
Care

• Frederick J. Pearce, Ph.D.
• Chief, Department of Resuscitative Medicine
• Walter Reed Army Institute of Research
• May 2006

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Yesterday
Today
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Conventional Solutions
NO DEVICES
DISCRETE DEVICES
Discrete Items
PATIENT BRIDGES
RACK-and-STACKS
Bridges
Shelves
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Integrated Solution LSTAT

• Defibrillator
• Ventilator
• Suction
• Monitoring
• Blood Chemistry Analysis
• Fluid/Drug Infusion
• Data Storage
• Data Transmission
• On-board Battery
• On-board Oxygen
• Wall/Vehicle Power
• Wall/Vehicle Oxygen
• Wheel System Interfaces
• Vehicle Compatibility

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Ground Ambulance 4 litter supports

• Constrain external dimensions to existing NATO
  stretcher envelope
• Avoid diminishing vehicle patient transport
  capacity
• Avoid need for vehicle retrofits
• Accommodate Army/Navy/Air Force and Marine ground
  and air evacuation vehicles

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Loading the UH60 Blackhawk Carousel
Single patient configuration Patient Movement
Items
Two patient configuration LSTAT
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Forward Surgical Team Concept of Operation
212th MASH Camp Bondsteel, Kosovo Movie
Pre Op
Inbound
FST Scenario, Pacific Warrior FTX Movie
Intra Op
Post Op
Evacuation
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LSTAT Applications Land
IN-HOSPITAL
PRE-HOSPITAL
MILITARY
U.S. Navy
U.S. Army
CIVILIAN
Urban Trauma Center
Rural Ambulance
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LSTAT Applications Air
LONG-HAUL
SHORT-HAUL
MILITARY
C-130
Blackhawk
CIVILIAN
Commercial Airline
Rural Aeromedical
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LSTAT Applications Sea
ASSAULT/TRANSPORT SHIP
HOSPITAL SHIP
USS Tarawa
USNS Comfort
USS Peleliu
USNS Mercy
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LSTAT versus Military PMI

• LSTAT
• Same deployed weight and volumeBUT
• 75 Fewer shipping containers
• 70 Lower shipping volume
• 30 Lower total shipping weight
• 95 Fewer manuals
• 80 Fewer power supplies
• 67 Fewer caregivers to transfer patients
• Equipment stays with patient
• Cant be lost, stolen, borrowed
• Simplifies inter-service hand-off
• Significantly improves patient safety during
  transport
• Significantly greater medical, data, ops
  capability
• Patient Movement Items

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Conclusions LSTAT Applications to Mass Disaster

• On-scene triage, stabilization
• Transport critical cases to make room for more
  victims
• Transport
• Care en route
• Vehicles of opportunity
• Facilities of opportunity
• Continuous data storage and transmission
• Patient, Equipment, Environment
• Transport to specialized hospitals (e.g., burn
  victims)
• In-Hospital care
• Provides flexible ED/ICU/OR capability to meet
  surge demands
• Requires fewer staff to manage patients
• Continuous care during in-hospital transport
• No loss of equipment or patient data - from scene
  through hospital
• Future capability includes Patient Isolation

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LSTAT Applications Regional Response
PORTABLE HOSPITAL CAPABILITY
REGIONAL HOSPITAL
DISASTER SITE
DATA CENTER
INTER-HOSPITAL TRANSPORT
PRE-HOSPITAL TRANSPORT
PORTABLE ISOLATION
LOCAL HOSPITALS 1, 2, 3,..
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LSTAT Applications Unique Situations
SARS Avian Flu?
CHEMBIO
-vs-
Intensive Care Environmental Control
Isolation
Isolation
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Future Directions

• Patient Isolation
• Closed-Loop Control
• Embedded Training
• Oxygen Generation