John Steinbaugh, a former Special Operations medic, knows how to stop bleeding on the battlefield. During more than a dozen deployments in Iraq and Afghanistan, Steinbaugh tended to fellow soldiers, often packing wounds with gauze.
The bandaging process, however, takes time and requires specialized training — two factors that led the Army to seek proposals for a faster, even instant treatment method.
Think Fix-a-Flat, the foam used to seal up tires, but for bleeding.
The military found a sponge-inspired answer with XSTAT, a device developed by the Wilsonville, OR-based company RevMedx.
With a syringe-like applicator, the hemostatic tool injects small, rapidly-expanding sponges into a wound cavity.
In 2012, Steinbaugh joined RevMedx, and he currently works as a liaison with the military, incorporating their feedback into new products like XSTAT.
Tech Briefs spoke with Steinbaugh about how the story of XSTAT began, and how the technology may play a greater, everyday role in the future.
Tech Briefs: What challenges did you deal with as a medic that inspired the development of XSTAT?
Steinbaugh: The major challenge for medics on the battlefield is speed of treatment. If somebody gets wounded on the battlefield, [stopping the bleeding] requires a medic to open up a gauze-type dressing, pack it with his fingers into the wounds, and apply direct pressure — sometimes for 3-5 minutes. For a medic or solider on the battlefield, 3-5 minutes can be an eternity. Medics have come back and said, “We need something faster, where you just put it in; fire and forget; and the bleeding stops.”
Guys would say, “We need Fix-a-Flat, but for bleeding.”
Tech Briefs: What exactly is XSTAT? What does it look like?
Steinbaugh: Picture if you were to go down to Williams Sonoma or some place that sells your 4 x 6-inch kitchen sponge.
If you were to punch the kitchen sponge, which is compressed already, into little discs, those pieces are still going to expand when you run them under water. Now put the pieces in an applicator, much like a 60-cc medical syringe with a big opening in the front. When you inject all those sponges inside of a gunshot wound, they still want to expand when they make contact with the blood — just like it’s water.
Tech Briefs: And you inject the sponges?
Steinbaugh: You inject it right at the point of injury. If a solider gets shot, a medic or fellow soldier can then pull out that applicator, stick it into the wound cavity as close to the source of bleeding as possible, inject it, pull out the empty applicator, and he’s done. The sponges will expand over the next 20 to 30 seconds as they absorb blood and create more pressure inside that wound.
They create pressure that is a little higher than your normal arterial pressure — enough to stop the bleeding, much like if you put one finger on a cut and applied pressure. That’s what those little individual sponges are doing inside the wound cavity, except you have a hundred little fingers applying pressure to the walls of the cavity and pushing against any vessels that are injured.
Tech Briefs: What is the material of the sponges that you use?
Steinbaugh: Regenerated cellulose. We make our sponge with the same wood-pulp materials that 99.9 percent of sponges in the world are made of. The difference is that almost all the sponges in the world are filled with very toxic chemicals to kill mold. If you’re going to build a medical device, you cannot have those chemicals in it. We had to create our own sponge that was biocompatible with internal use of the human body.
Tech Briefs: What was it like when you first used the device in the lab?
Steinbaugh: I actually flew out to Oregon, and they had some prototypes and a lab set up. I actually got to try the product on some bleeding [in animal testing]. I injected it and I was like, “…Is that it?”
They said, “Yeah, you’re done…”
And I said, “You gotta be kidding me.”
From that point forward it went into overdrive with the military. The military funded the company to accelerate this program, trying not to lose the magic that they got right out the gate.
Tech Briefs: Is XSTAT designed for just medics?
Steinbaugh: We always said in the military that packing a wound is a perishable skill. You have to be good at it. You have to know anatomy, you have to know how to pack the gauze, you have get it to the point of bleeding and apply pressure with it.
You take your average law enforcement officer or person on the street — they’ve never packed a bleeding wound their entire life.
That’s the beauty of XSTAT. All you have to do is get the injector into the wound and then press the handle. The sponges will move and wiggle their way into every nook and cranny of a jagged wound and apply pressure, with no training required. We would want this to be the go-to product for anybody that needs to stop bleeding, because it’s that simple.
Tech Briefs: Have recent shootings in the U.S. created a different focus for your company?
Steinbaugh: It hasn’t changed the way we do business here. The product works. What it has changed for us is we’re getting a lot more emails from school districts or public places saying, “Hey, we’re building kits for our mall or our movie theater.” Or “Our high school wants to buy a medical kit for every classroom,” so they reach out to us about our product.
In that regard, we’ve taken a focus that’s been 100% on the military and hospital ER paramedic [applications], and we’re now thinking a little differently: “Ok, how about just a regular civilian community?”
Tech Briefs: Is XSTAT simple to manufacture?
Steinbaugh: No, it’s not. You would think, looking at it, that it’s just sponge, and it should be super easy and super cheap to do. In fact, it’s relatively complex. The bioburden on the sponge has to be below a certain threshold to be allowed to pass all the FDA regulations for being used in the body. Each individual sponge is cellulose and has to be removed the same way you would remove a gauze dressing. Each individual sponge has to have a marker on it to make it radio-opaque, so you can see the sponge on an X-ray.
Tech Briefs: What are you working on now?
Steinbaugh: A lot of people die from gunshot wounds worldwide ever year, but a lot more often women bleed to death after childbirth — postpartum hemorrhaging. Because our technology is so easy to use, we’re working on modifying our technology to be used for postpartum hemorrhage. It’s very easy to put it in the hands in a midwife in Kenya who’s out in the middle of nowhere, and that could be used to save somebody’s life or buy them time to get them definitive treatment into a hospital. That’s been a big focus for part of our company lately.
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