Tiny sponges that soak up blood. That was the idea.
Or rather tiny sponges, injected into a wound, that soak up blood and, in doing so, expand to put pressure on the wound to help control bleeding. That was the idea.
It's one of those palm-to-forehead, "Really? Why didn't I think of that?" things. It's also real, in production and coming to an ambulance near you. Because, simple as it may sound, it's an idea that works.
The U.S. Food and Drug Administration has OK'd the use of XStat, a medical device designed and manufactured by RevMedx, an Oregon company. XStat already had been approved for use for the military, which has been using it since 2014. Now, first responders throughout the U.S. — paramedics, firefighters, EMTs — can use XStat, too, for major injuries where a tourniquet is not adequate and emergency care is still a ride away.
"When a product is developed for use in the battlefield, it is generally intended to work in a worst-case scenario where advanced care might not be immediately available," says Dr. William Maisel, the acting director of the Office of Device Evaluation in the FDA's Center for Devices and Radiological Health, in this FDA release. "It is exciting to see this technology transition to help civilian first responders control some severe, life-threatening bleeding while on the trauma scene."
The XStat is pretty much what it appears to be, even to the nonmedically inclined among us: a syringe full of tiny sponges. The syringe designed for the battlefield is 30 millimeters in diameter (a narrower version is 12 millimeters in diameter) and holds 92 compressed, aspirin-sized sponges.
The device also works like you would expect it to: A health care professional plunges the syringe into the wound, injecting the sponges. Each sponge, made of wood pulp, is coated with a blood-clotting agent and a marker to make it easier to spot via X-ray for later removal.
The sponges soak up blood, get some coagulant into the area and — because they swell to up to 15 times their size — put pressure on the wound to slow bleeding. Also important? They adhere to moist surfaces. The whole process, depending on the size of the wound, takes about 20 seconds until the wound is filled and the bleeding is under control.
The concept was conceived when U.S. medics, during the Iraq War, were looking for better ways to control bleeding on the battlefield until injured soldiers could be evacuated to hospitals.
"The way the medics described the device they wanted was 'fix-a- flat,'" RevMedX's John Steinbaugh, a retired Army medic with more than four years of combat experience, tells PBS in the below video. "So if you think of your tire, you inject the fix-a-flat into your tire, it finds the escaping air, it plugs it, and done."
There are plenty of possibilities for XStat's use in civilian life, too, now that it's been FDA approved. The FDA, citing statistics from the Army Institute of Surgical Research, says that 30 to 40 percent of civilian deaths by traumatic injury are the result of hemorrhaging. And of those deaths, 33 to 56 percent occur before the patient reaches a hospital.
The XStat will not work for every traumatic wound in every case. It's designed for wounds in the groin or armpit (axilla) regions, where tourniquets are not effective. It's designed to stop traumatic bleeding only when emergency care can't be reached within minutes. (The device, according to RevMedx, is effective for up to four hours.) It is not intended to be used in the stomach or chest areas, or in the throat.
But the civilian version will work, as Steinbaugh told PBS, for smaller wounds to the extremities, like smaller-caliber bullet wounds and for deep cuts from knives or other sharp objects. RevMedx also is producing a gauze embedded with the sponges.
Simple ideas, perhaps. But they're ideas that could end up saving lives.