As the driver eases the ambulance off the icy highway, an agitated young man comes running from the overturned BMW. Holding his left arm gingerly to his side, he gestures excitedly with his right.
"It's my wife. You've got to help her," he yells.
The woman sprawled on the ground looks unscathed in contrast to the car beside her, a crumpled tin can of a wreck. But the pain she feels in her abdomen makes it almost impossible to speak.
Without moving the victim, a medical technician reaches in his kit for an instrument that will detect her internal injuries. Like a magician waving a magic wand, he glides a fist-sized scanhead over her abdomen. In his hand a miniature ultrasound machine displays an image from inside her body. As he watches the screen, he recalls that just a few years ago, this particular device was the size of a washing machine and would have been impossible to take to the scene of an accident.
Via a satellite link, the ultrasound images also appear on a screen at a hospital 20 miles away. A radiologist determines that the woman has a ruptured spleen. She is likely to bleed to death before she reaches the hospital.
The doctors radio to the emergency technician to alter the frequency of the ultrasound waves. Now, he directs a beam of high-intensity, focused ultrasound to the site of the bleeding. The flow of blood slows--then stops long enough to transport the woman to the hospital, where doctors rush her into surgery.
For severely injured victims of car accidents, shootings, falls and industrial accidents, the first hour often makes the difference between life and death. While it isn't here yet, the UW is working to bring this technology to hospitals and medic units across the country.
"The more quickly life-threatening conditions can be diagnosed, the more quickly treatment can start," says Lawrence Crum of the UW Applied Physics Laboratory. "An ultrasound examination can reveal if body organs are distorted because of internal bleeding, where blood may be pooling in the abdomen, if blood is flowing through key vessels and where shrapnel, bone and debris have been driven into the body."
Figuring out how to provide aid during the critical "golden hour" has been the impetus behind a number of projects involving University of Washington researchers. But the research dollars do not come from federal health agencies as you might expect--they're from the Department of Defense.
The instruments used in this hypothetical accident could be a reality in three to five years and find their way to both civilian and military arenas, Crum says, which is why they are being funded with defense dollars.
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