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Roy Nadler , Victor A. Convertino, Gadi Lending, Sami Gendler,

The value of non-invasive measurement of the Compensatory Reserve Index in monitoring and triage of patients experiencing minimal blood loss. Roy Nadler , Victor A. Convertino, Gadi Lending, Sami Gendler, Ari M. Lipsky, Sylvain Cardin, , Elon Glassberg. ענף הרפואה המבצעית, מקרפ"ר.

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Roy Nadler , Victor A. Convertino, Gadi Lending, Sami Gendler,

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  1. The value of non-invasive measurement of the Compensatory Reserve Index in monitoring and triage of patients experiencing minimal blood loss Roy Nadler, Victor A. Convertino, Gadi Lending, Sami Gendler, Ari M. Lipsky, Sylvain Cardin,, Elon Glassberg ענף הרפואה המבצעית, מקרפ"ר

  2. IDF-MC Mission for 2020: Eliminating preventable death Triage & Monitoring

  3. Key concepts 90% of potentially salvageable casualties exsanguinate Early detection of hemorrhage is crucial Rapid evacuation & treatment as main objectives Prioritizing is a key concept of point of injury care

  4. The gap with currently available Indices Volume of blood lost Desired vital sign Available vital signs

  5. Triage criteria limitations

  6. The Compensatory Reserve Index (CRI) • Assessment of physiological reserve • Non-invasive recording & analyzing of the arterial waveforms using machine learning techniques. • Ranges from 0 (complete decompensation) to 1 • Has been shown to correlate with central blood volume loss in laboratory conditions1 • Not operator dependent, Small and non-invasive device Convertino VA et al. Use of Advanced Machine-Learning Techniques for Noninvasive Monitoring of Hemorrhage. J Trauma 2011;71: S25–S32

  7. Patients and Methods 264 Subjects Test Group (donated blood) N=230 Control Group N=34

  8. Pre & post blood donation Δ 5% Δ 3% Δ 18%

  9. Differences – study Vs. control group

  10. One time measurements Blood loss No Blood loss

  11. Results

  12. Results

  13. Results

  14. Results

  15. Results P= 0.02

  16. Sensitivities and specificities of CRI

  17. Current triage models

  18. Limitations • Technology under development • Tested in sterile environment

  19. Summary • In our study CRI demonstrated superiority over conventional vital signs in detecting mild blood loss • CRI shows potential as a triage and monitoring tool • Unknown value in life-threatening hemorrhage • Unknown value in non hemorrhaging patients

  20. IDF-MC Mission for 2020: Eliminating preventable death

  21. The value of non-invasive measurement of the Compensatory Reserve Index in monitoring and triage of patients experiencing minimal blood loss Roy Nadler, Victor A. Convertino, Gadi Lending, Sami Gendler, Ari M. Lipsky, Sylvain Cardin, Elon Glassberg ענף הרפואה המבצעית, מקרפ"ר

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