Forum Summary

Trauma care and critical care have great potential to be improved by new technology.  In the pre-hospital setting, fluid resuscitation and bleeding control are vital.  Blood is a complex substance and is imperfectly understood.  When a healthcare provider separates blood into different components and then gives a patient these components one by one, the provider is not replacing natural blood with an identical substitute.  Colloids and crystalloids, which are widely used for volume repletion, are not as effective as whole blood.  If one gives a patient fresh whole blood, “popping a clot” is usually not a major concern because the patient will make a new one.  Before one gives a patient a blood product, however, one must recognize the patient’s need.  Patients could receive fluid resuscitation in a more timely fashion if there were better technology for detecting internal bleeding.  New hemostatic agents are also needed to control bleeding.  In many military settings, it is impossible to hold pressure to a wound.

In the hospital, new technology is also needed, and much of this technology appears to be within reach.  Patients in the intensive care unit (ICU) are often connected to many wires, complicating treatment.  Wireless monitors would improve patient care and would be relatively easy to create given the extensive wireless technology in use today in other industries.  Better data presentation in the ICU would also improve clinical care.  Maintaining electrolytes at appropriate levels, for example, is a task that could essentially be accomplished by a computer.  Harnessing digital photography and video technology would also help surgeons communicate about patients, but the introduction of this technology would have to be consistent with patient privacy regulations.      

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