In The Field: A new way to keep an eye on traumas inside the skull

Opeolu M. Adeoye, M. D., Emergency Physician, UC Heath Neuroscience Institute

I’m an emergency physician. I work in the ER and the Neuro-Intensive Care Unit [at the University of Cincinnati Medical Center], and I take stroke call for the city [the UC Stroke Team covers all hospitals in the region]. Of the ICU patients who have initial bleeding from traumatic brain injury or hemorrhagic stroke when they come in, at least half of them have more bleeding over the course of the next day or two. With current neurological monitoring, the best we have is the patient.

We wake people up every hour on the hour for days on end. If they’re worse and stay worse, we get another scan. Depending on what we see, we intervene with medications or surgery. There’s an opportunity where the patient is having more bleeding, but hasn’t bled to the point to be permanently damaged. The goal is to see if we can identify the bleeding as it’s happening so we’re prompted sooner rather than later to intervene.

There are four of us involved in SENSE—Sensor Evaluation of Neurologic Status in Emergencies: Joseph Clark, PhD; Matthew Flaherty, MD; and George “Chip” Shaw, MD, PhD. It is electromagnetic frequency monitoring. You put an electromagnetic pulse through the brain, and if something changes, you have a shift in what’s received. It seems so simple and straightforward, and there are other iterations of this for different areas of the body.

The two patient populations of interest for SENSE are the hemorrhagic stroke and the traumatic brain injury. Traumatic brain injury is a big deal. It affects about 1.7 million people annually in the United States. If we get past that, then we would be able to see if we can also detect seizures and brain swelling.

The National Institutes of Health funded the original studies. UC is funding us now, with the UC Technology Commercialization Accelerator Entrepreneur-in-Residence Dan Kincaid’s guidance.  The Department of Emergency Medicine also has what we call “the medical device engine,” a division geared toward informing medical device companies about products. Industrial designer Mary Beth Privitera has been coming up with original prototypes, bringing DAAP students to the bedside and looking at the ICU environments and seeing what’s possible and what’s not. There’s a great integration of resources from the clinician, the designer, and the businessperson. UC has taken this on in a way that channels all the resources available. It not only makes sense for the university, but for patients in the long haul.

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