The Cadillac of First Aid Kits Could Turn Civilians into Life-Savers | WIRED
EARLIER THIS YEAR, Collin Smith came into possession of an “intelligent” first aid kit. When he did, the first thing he did was try to outsmart it.
The kit in question was the Comprehensive Rescue System, a sturdy, gray, 17-pound case of supplies custom-built by emergency management startup Mobilize Rescue Systems. It contains gauzes, bandages, and ointments like any first-aid kit, but also carries tourniquets, chest seals, and QuikClot—the kind of stuff you hope you’ll never have to use, but that can keep someone with severe injuries alive while they’re waiting on an ambulance.
But a first aid kit is only as effective as the person using it, which is why Smith wasn’t interested in the supplies so much as he was in the iPad embedded in its lid, which came installed with an interactive app that distills some 1,600 pages of triage and emergency-response decision-trees drawn up by Mobilize Rescue’s team of SWAT- and military medics, emergency medicine physicians, EMS providers.
Smith, who oversees the Colorado School of Mines’ Energy, Mining, and Construction Industry Safety Program, has worked as a mine rescue trainer or team member for close to a decade. Having dealt firsthand with everything from heart attacks to crushed limbs, he immediately recognized the kit’s potential when he saw it at an industry conference in February. (The kit launched in December 2016.) The information in the app is presented in a series of simple, on-screen prompts designed to identify and treat the most serious injuries first. The goal: Make it as easy as possible for bystanders to provide lifesaving care to trauma victims.
“On remote job sites, a paramedic is almost always more than 20 minutes away,” Smith says. “And depending on the injury, you may not have 20 minutes.” Sure, you can train employees in first aid for severe trauma. But training wears off, and emergencies are stressful. “In a high-pressure scenario, you might not remember what you were taught six months ago, so it helps to be guided through it.”
Traumatic injuries have killed more than 2 million US civilians since 2001 and are the leading cause of death among Americans below the age of 47. Roughly half those deaths occur at the place of injury or on the way to a hospital. The National Academies of Sciences, Engineering, and Medicine estimates that, of the 147,790 deaths from trauma in 2014, as many as 30,000 of them could have been prevented with better, faster medical care. Mobile Rescue designed the Comprehensive Rescue System with these statistics in mind.
To see if the kit functioned as advertised, Smith and his three-person team of emergency medical specialists quizzed it with scenarios involving severe breaks, burns, bleeds, and traumas that are difficult to diagnose, or whose treatment protocols had recently changed. Injuries like a severe lower-leg break with an arterial bleed. Smith says the protocol used to be to apply direct pressure to the wound, then to a major artery in the groin. “But even experts have a hard time finding that pressure point. You’re sitting there digging into the victim’s groin while they lie there screaming and bleeding out,” Smith says. “The new protocol says: If direct pressure doesn’t work, move straight to a tourniquet.” Which is exactly what the kit prescribed.
Smith and his team spent three weeks conducting this initial round of tests. They ran hypothetical, pen-and-paper scenarios with firefighters, and brought in a training dummy with moulage to test laypersons with zero medical experience. “The kit handled everything we threw at it,” Smith says.
Smith was so impressed, he’s incorporated the kit into his program’s Mine Safety and Health Administration training courses, and advocates for its adoption throughout the mining industry. “Something like this, especially for remote locations, could be as valuable as fire extinguishers of sprinkler systems, when it comes to increasing your probability of survival,” he says. “It’s a big deal. I would not be surprised if you saw something like this become standard at job sites in the future.”
What sets Mobilize Rescue’s kit apart from other heavy-duty kits is the relationship between its contents and the interactive app. The screen displays color-coded illustrations, animations, and planograms to help users locate supplies in the kit’s bottom half and provide step-by-step instructions for their use. (With the exception of a metronome that plays during the instructions for CPR, the kit provides no audio cues.) Those supplies are arranged according to whatever will kill you fastest, in an inverted-horseshoe shape.
“You can bleed to death in three minutes—that’s way faster than you’ll choke to death, so tourniquets, labeled red, go in the bottom left,” says Chris Strattner, Mobilize Rescue’s head of product development. Above those, marked in yellow, are pressure dressings and packets of QuikClot. Chest seals, labeled green, go above that. Moving across the top of the kit, you’ll find things like glucose, a CPR mouth-shield, and burn dressings, labelled pink, blue, and grey, respectively. Matching the kit’s contents to the on-screen instructions is like the easiest game of Apples-to-Apples you’ve ever played—only, you know, with higher stakes.
The kit’s got supplies for less critical situations, too. Splints, cold compresses, that kind of stuff. “And then, on the bottom right, there’s a little pouch in there with a bunch of bandaids. Because if you don’t have enough bandaids in your workplace, the OSHA guys will come and put you in OSHA jail,” says Strattner.
The fact that the Comprehensive Rescue System is approved by OSHA and the American National Standards Institute means that Mobilize Rescue can sell these kits not just to industry types, but schools, offices, airports, stadiums, and malls—which are also some of the only places that will be able to pay for them. The kit’s biggest drawback is its price: $2,250 for the hard-case model, $1,750 for the more portable soft-case. (The company does offer a smaller, sparser, $180 kit, the app for which runs on the user’s cell phone—but it’s a less impressive product, holistically.)
“It’s the Cadillac of first aid kits, but not everybody can afford a Cadillac, and affordability is everything when it comes to consumer-level first aid kits” says Dave Hammond, who has been designing color-coded, audio-guidance first aid kits for more than 20 years. “It’s an exceptional product, just very expensive. I mean, it’s comparable in price to an automated external defibrillator.”
Which might actually be a fitting comparison. The automated external defibrillator’s AED’s design made it possible for someone with no prior training to shock and resuscitate a heart attack victim. “It was the single greatest intervention for decreasing out-of-hospital deaths from cardiac arrest,” says Eric Goralnick, the medical director of emergency preparedness at Brigham and Women’s Hospital. “Today, we need to find the equivalent to the AED for hemorrhage control.”
On this front, Goralnick says Mobilize Rescue’s kit looks very promising. So promising, he’s currently designing a study to test the kits under tightly controlled conditions—similar to what Smith did, only more rigorous. “When you first pop this thing open and see the way it’s designed, the way the iPad walks you through all these steps—it’s impressive. It’s simple, clean, with clear descriptions. Comprehensive, too. It can do more than just hemorrhage control. It looks wonderful, very innovative, and I think solutions like this are certainly the future of first aid.”
“It’s exciting,” he says. “But now we’ve got to do our due diligence and test it.”