USAMMDA Warfighter Brain Health team puts TBI analyzer to test during Global Medic
Team members with the U.S. Army Medical Materiel Development Activity tested a developing technology recently in the ongoing effort to find medical solutions to help identify traumatic brain injury closer to the point of injury than ever before.
Program experts from USAMMDA's Warfighter Brain Health Project Management Office and Warfighter Deployed Medical Systems PMO joined leaders with U.S. Army Medical Research and Development Command and Medical Capability Development Integration Directorate to participate in a Soldier Touchpoint during the recent Global Medic Combat Support Training Exercise at Fort Hunter Liggett, California.
During the exercise, U.S. Army Soldiers assigned to the 566th Area Support Medical Company, 61st Multifunctional Medical Battalion, 1st Medical Brigade, trained for field medical operations at Role 2 level of care. Role 2 level of care is a battalion aid station staffed with combat medics and medical officers who treat combat-related trauma while arranging for movement to a higher echelon of care further from the front lines.
Simulated real-world exercises like Global Medic give USAMMDA program development teams valuable insight into how their programs and candidate products, like the Analyzer Traumatic Brain Injury (ATBI) system, are likely to impact operational medicine once integrated into the force and improves medical product refinement, according to Damien Hoffman, product manager of the ATBI program.
"Soldier Touchpoints provide real, direct, feedback from the intended end-user community," said Hoffman, who travelled to Fort Hunter Liggett for the training exercise and assessment. "These events provide opportunities for Warfighters to familiarize themselves with the medical products they might see in their sets, kits, and outfits and facilitates interactions between future-users and materiel developers to identify potential areas for improving integration within operational medicine. Events like Global Medic also provides development teams the opportunity to see the product of their hard work in the hands of the Warfighter, which is a rewarding experience and impossible to convey through paper exercise."
The WBH team's efforts are designed to help the Department of Defense move toward the ability to identify TBIs as close to the point-of-injury as possible. Integration of ATBI and related devices and supplies into realistic training exercises is a key step toward giving medical care personnel the ability to test for TBIs without needing to request medevac for radiological imaging such as CT scans.
The ATBI is intended to provide data to indicate the presence or absence of brain injury for Role 2 and 3 medical providers, which is critical to ensure prompt and appropriate triage, treatment, and evacuation decisions. This will be essential in future conflicts where ground and aviation-based medevac capabilities may be stretched thin or temporarily unavailable. Once fielded, the ATBI will give commanders and medical personnel objective information to help determine the need to evacuate for CT imaging due to injuries sustained during combat operations, according to Hoffman.
"From data collected in recent conflicts in Iraq and Afghanistan, researchers have seen an abundance of medevac for CT scans for potential brain injuries, many of which turned out to be CT-negative for TBI, meaning they did not require evacuation. The ATBI would allow these Warfighters to have a TBI ruled out, be treated locally, and progressively returned to duty," said Hoffman. "Unrequired medevac has a multitude of secondary and tertiary effects: reduction of unit manpower and combat lethality; unnecessary consumption of fuel and flight hours of evacuation asset; risks to personnel and military assets associated with flight in a battlespace; and unnecessary exposures to radiation during imaging scans. Implementing the ATBI will significantly reduce the frequency of preventable, unnecessary evacuations, subsequently reducing these secondary and tertiary effects."
According to the Traumatic Brain Injury Center of Excellence, there were nearly 473,000 TBIs among U.S. service members worldwide between 2000 and late 2022.
"Currently frontline medical providers must rely on self-reporting and other subjective clinical assessments to make triage and treatment decisions for casualties with potential TBI," said Hoffman. "With the ATBI, medical providers will have objective data at their fingertips to aid them in the triage and treatment decision process for Warfighters with an otherwise-invisible injury."
As USAMMDA and related Army medical development commands continue to focus efforts on medical treatment solutions designed for future conflicts, the ATBI program aligns to the wider modernization efforts of operational medical development. Lessons learned in Iraq, Afghanistan and other contingency operations are helping shape the WBH team's current efforts. While ATBI is a new capability to medical providers across the Joint Forces, it does emphasize an approach for developing the technologies that will be deployable, user-friendly, and widely applicable for the Warfighters of 2030, 2040 and beyond, according to Bobbie Mortimer, deputy project manager with WBH.
"TBIs are a major area of concern for combat medical care and are a focus area for Army medical development," said Mortimer. "During future combat operations, enemy weapons and exposure to blast or concussive events, and proximity to concussive events during operations will present challenges to frontline medical providers. The ATBI program is part of our effort to research, develop and field modern solutions for future combat medical care challenges."
The Abbott Point of Care Inc. i-STAT Alinity plasma TBI* test is the first FDA-cleared blood test that is commercially available for health care systems in the United States for clinical, non-military uses to provide objective data regarding the presence of TBI.
"The ATBI is a fast and effective FDA-cleared assessment device that can give theater-based medical providers near real-time test results to make treatment decisions. The WBH team forecasts fielding and integration of the technology in 2025. While the test alone does not diagnose TBI nor quantify TBI severity, it does provide valuable information regarding the presence or absence of markers in the blood that may indicate brain injury," said Mortimer. "The results of the ATBI test, along with other clinical data, will improve triage and evacuation priorities during dispersed operations and inform treatment at higher echelons of care once a casualty is moved. The ATBI is portable, user-friendly, reliable, and accurate, and it gives frontline medical providers a needed edge in providing medical care in austere locations, where every minute counts to save lives and preserve combat strength."
* The laboratory assay for TBI point-of-care biomarker effort has been funded by the U.S. Army and is managed by USAMMDA's Warfighter Brain Health Project Management Office.