Photo By Capt. Brandon Janson | OIR CJTF MED 374 Sgt. Samantha Smith, LAB NCO, prepares a TBI plasma blood sample...... read more read more
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By Capt. Brandon Janson
The Laboratory Service team, co-led by Maj. Roderick Clayton and Staff Sgt. Emily French are making some big changes in the way TBIs (traumatic brain injuries) are diagnosed and treated in the battlefield setting. Currently serving in the middle-east in support of the Joint Coalition Task Force—Operation Inherent Resolve (JT-OIR), this small team is actively implementing and collecting data on a new lab process technology that isolates specific elements that are released in the bodies blood stream following a traumatic injury of the brain—more commonly referred to as a TBI or concussion.
“The rollout and the verification process for the test was initiated and implemented by the previous unit [TF 16 MED] and Force Command. We are now overseeing all the other aspects of the project,” said French, Laboratory Non-Commission Officer in Charge (NCOIC). “Using a simple blood test, we can now determine if a Soldier has sustained a TBI in a much shorter time. The instruments are now in place at all our sites, and we are just trying to be sure the different locations are running the tests and maintaining their monthly logs.”
According to the manufacturing website, Abbot, the new TBI plasma blood test has been approved for testing by the Food and Drug Administration (FDA) and is performed using a mobile handheld blood processing tool called the ISTAT Alinity, a miniature blood testing device. A small blood sample is collected and then placed on a specialized cartridge that is then inserted into the ISTAT machine. The test specifically targets the Glial Fibrillary Acidic Protein (GFAP) and the enzyme ubiquitin carboxy-terminal hydrolase (UCH-L1), which have been strongly associated with a TBI occurring. Prior to this test, TBI and concussions have been diagnosed based on patient symptoms and attaining a head CT scan. Imaging is still the primary means for determining whether a TBI has occurred but is now conducted concurrently with biomarker blood testing.
The Center for Disease Control (CDC) website records that approximately 223,135 hospitalizations were related to TBI injuries in 2019 alone, and 450,000 service members have been diagnosed with TBI since 2000. A TBI occurs when a service member experiences internal or external trauma to the head, which can alter the way their brain works and functions. Blast injuries are the most common cause of TBIs for Soldiers.
This represents a rather large incidence of the disease and an increased need to properly identify and diagnose TBI in a timely manner, especially when operating in remote areas or areas that have long transport times.
According to the CDC website, varying levels of damage to the brain can occur as a result of a TBI, which can be accompanied by several symptoms including confusion, irritability, impulsivity, and memory loss, to name a few. Mild and moderate TBI symptoms are difficult to identify as they do not always present with the obvious symptoms and require complex diagnostics to determine that a TBI has occurred, such as CT scanning.
The treatment for the TBIs is the same regardless of how a TBI is diagnosed, however attaining a head CT to rule out a TBI or concussion can be a logistical challenge, requiring the Soldier suspected of the head injury to be MEDEVAC’d to a facility that has CT capabilities. This incurs a rather high dollar amount which inadvertently pulls resources on the battlefield. The full introduction of this biomarker blood test will help positively identify TBI cases and decrease the time and cost related to Soldier transportation and CT imaging.
To roll out the new Biomarker testing and begin testing at each of the sites, French and her laboratory staff have been visiting each of the down trace medical units to ensure they are educated on the new equipment and process.
According to laboratory staff, the operation has required hours of oversight, endless email traffic, meetings, phone calls, and technical assistance from a multitude of personnel, including Lt. Col David Milia, TF MED 374 Trauma Director, Lt. Col. Robert Bejnarowicz, a TF MED 374 Neurosurgeon, Futures Command, and the laboratory technicians throughout JTF-OIR. The technology and equipment are so new that the software for the laboratory equipment had to be hand-delivered to theater and then distributed to each site.
“CT scans of the head are still used to aid in the diagnosis of patients suspected to have an mTBI; an estimated 90% have negative results for clinically important injuries. The short turnaround time provided by the Abbott iSTAT Alinity minimizes needless CT scans and radiation exposure while expediting the diagnosis of TBI casualties,” said Maj. Clayton, who currently serves as the senior lab officer for TF Med 374. Additionally, Clayton oversees all the other down-trace laboratory services in support of Operation Inherent Resolve and directly manages the Area Joint Blood Program Office (AJ-BPO), an essential blood program that coordinates and supplies blood products in-theater.
| Date Taken: | 11.01.2022 |
| Date Posted: | 01.04.2023 11:38 |
| Story ID: | 434429 |
| Location: | IQ |
| Hometown: | CHICAGO, ILLINOIS, US |
| Hometown: | INDIANAPOLIS, INDIANA, US |
| Web Views: | 168 |
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