Digital Finger Clip Could ‘Revolutionize’ Battlefield Triage

CRI-Army-600x400The Army is looking at a device the size of a matchbook with a computer display that would immediately provide a wounded soldier’s vital signs on the battlefield.

Army doctors say it could “revolutionize triage” because the immediate vital signs such as body temperature, heart rate, breathing rate and blood pressure would allow doctors to figure out who was at the most risk.

Called the Compensatory Reserve Index, or CRI, device, the plastic clip the size of a matchbook connects to a soliders finger. It then feeds the vital signs directly to a digital tablet the size of a standard iPad. The tablet can display more than one solider’s vital signs allowing a medic or doctor to more easily make decisions on who to treat first.

U.S. Food and Drug Administration officials are currently testing the device and then Army medical leaders will decide whether to field it. Army officials showed support for it by displaying it on Friday at the Pentagon’s first ever Lab Day.

The CRI is also designed to sustain battlefield conditions and harsh weather.

Israeli soldiers are already using the device. U.S. Army officials have seen the number of lives it has saved already, said Lt. Col. Robert Carter, task area manager for Tactical Combat Casualty Care Research at the U.S. Army Institute of Surgical Research.

Army scientists could also use the device utilizing special software to predict if a patient is going into shock. Researchers at the U.S. Army Institute of Surgical Research, in collaboration with colleagues at the University of Colorado, Children’s Hospital Colorado and Flashback Technologies, Inc. developed the software using the vital signs and are testing it now.

  • IAC

    Is the device also compatible with a Tricorder ?

  • Fitbit on a finger? Wouldn’t they prefer an Apple smart watch (LOL)?

  • dhp

    that haircut though

  • ZP13

    Huge opportunity here to expand the number of patients you could triage and relieve nurses/corpsmen from constantly monitoring awaiting patients so they can assist with incoming patients and surgery. Also could see this getting applied into medevac platforms where surgeons at the trauma center could monitor upcoming patients and have a game plan before they arrive. Really milk that golden hour for all it’s worth.

  • Scott Mayhew

    Another gadget to allow our soldiers to sleep through their jobs. Physically obtaining vitals by putting hands on the patient is a vital skill that leads you towards a path of treatment. These devices that attach to a finger are not reliable. All this does is assist thte chronically lazy and will allow those unfit to serve as medical professionals. Nurses belong in a hospital, not in the field. Perfect for the TMC.

    • Pete

      Well said. Having used pulse oximetry in the field for years and thus using a similar device to base split second decisions on fills me with dred.

    • Peter Emig

      You may have forgotten that many military nurses were previously medics. Nurses belong where they are needed, both in hospitals and in the field. I served in combat as a Navy Corpsman AND as an AF Critical Care Air Transport Team member and am comfortable in pretty much any environment. Over the years my experience has taught me that sweeping generalizations about ANY group of people are never a good idea.

      • SAM

        After having been properly trained in PHTLS and TC3, maybe. I have had many encounters with nurses pretending to be prehospital care providers, it doesn’t work out well most of the time. There is a world of difference between nursing and prehospital emergency care. Some do not transition well. They all want to draw blood for lab work and check blood sugar as the patient is circling the drain. If I had a quarter for each time a damn nurse tried giving me instructions in a ditch, inside an overturned vehicle I would not have to sit at this desk anymore.

    • Charlie

      This device is NOT for the “chronically lazy”. This device measures what humans physically cannot! It tells a medic/corpsman whether a patient is bleeding internally and how bad it is. We don’t have time to do a full trauma assessment when there’s multiple bodies that need attention! Any piece of equipment we can get to help save a dying patient multiplies our capabilities and is greatly appreciated!

      • SAM

        No time to do a full trauma assessment? I seriously hope that you never respond anywhere that I am working. So what can we physically not do? I have no problem doing all of this stuff. How exactly does this tell me if my patient is bleeding? It is great for a CCP, BAS, TMC or FAST location. I would not throw it in my bag, unless I was going to a fixed location. The day that I can no longer determine my patients status should be the day after I stop treating patients. Again, a nice tool for the proper place and time, but it should not replace good medical practice in the field.

  • Ramon

    Great saves lives

  • Sev

    Isn’t this exactly what they have at most hospitals these days? The little finger clip with the laser that takes your pulse?

    • SAM

      This does more, from a fingertip, if I read the article correctly. There are a few reasons why this will not work 100% of the time. It would be fine in a clinic where vital signs are not important but mere scheduled events to prove that care is being provided. In the life or death prehospital emergency care, this is irresponsible as someone who would rely on a device like this should never be allowed to do patient care because emergency care involves never letting your guard down until the patient is stabilized and a complete diagnosis has been done. This would also not work in a medevac scenario. Emergency patients do not hold still, hypothermia, diabetes, dirty hands, fingernail polish and other things make these types of instruments unreliable. Good for a clinic though.

      • Me in MO

        And yet one of the finest militaries in the world, the Israelis, are using them. Go figure. Guess they still have a thing or two to learn about combat. /sarcasm

        Although I work in a technology field, I’m not a huge fan of automating for the sake of automating. You still have to have a COMPLETE grasp of the basics. In fact, you can label me a bit of a Luddite as something like GPS should NEVER totally replace something like mastery of the map and compass. You still should stress the basics. But this isn’t a done deal. They’ll be testing it and, if it’s faster, reliable AND saves lives then I’m all for it, with those caveats.

        • SAM

          I highly doubt that any qualified experienced combat medic, US or Israeli, would pack this in their dismount bag. If you have gone through the training that the US and Israel put their medics through, especially a preMOB training since 2008, there is no way that you would even think about bringing this to the field. This item is great for the TMC, BAS or FAST location, where you have a controlled, clean and predictable environment. During a long transports in a medical transport it may be an asset, but not for active MEDIVAC, QRF platrorm or TC3 environment.

          Only a fool places the lives of his casualties in the hands of a bunch of battereis.

  • Destro

    Treat the patient, not the machine

  • Peter Emig

    The little finger tip used in all hospitals is just a pulse oximeter. It only measures the amount of oxygen in your blood and your pulse. Many people forget that technology like this has the great potential for failure in austere conditions like the field. Rather than asking Army doctors their opinions maybe they should actually ask those that would have to use it, the medics and nurses that function in those environments. I was an AF Trauma RN/CCATT and before that a Navy Corpsman and the vast majority of all care (and Triage) is done by medics and nurses. Doctors should stick to equipment they will use. Having served in Iraq twice I can see many problems with this equipment. How well does it work in aircraft or bouncing military vehicles. The ability to triage mass casualties is an art form that requires years of practice in the real world. Very quick assessments that provide very limited information are usually worthless. I’ll take a BP cuff and my two fingers anytime and can get the same info in 30 secs.

  • Ranger Doc

    Great discussions and experience is certainly a valuable thing. What this device aims to do is identify the earliest of compensated shock before tachycardia develops and hopefully way before hypotension results. No one is doubting the ability of experienced prehospital medics to identify hypotensive/decompensated shock, but this is one potential technology pushing the envelope of early detection of compensated shock before any one or current combination of vital signs obtained manually predict or indicate compensated shock. Keep up the the scrutiny and discussion as our men in women in harms way deserve all our mental capacity and effort.

  • Eric B.

    If it performs as advertised this device will make its way to ALL civilian first responder EMT/Paramedic units as well as ski patrols.

    Already we use oximeters (finger tip O2 saturation indicator clips). This new device merely broadens the number of parameters measured.

  • S.Yuval

    every Israeli paramedic unit also carries conventional BP and PO equipment- this does not replace them. Ranger Doc above, and a couple of other folks nailed it. this thing has great potential to identify early compensated shock before tachycardia and hypotension and all the other grave problems. but we still use the M-1 eyeball and experience and training, and the rest of the gear as well. the article did not state whether the device was in a go-bag on the battlefield, or in a slightly rearward catchmet unit where things are slightly less dirty, etc. and “Me in MO”, go ahead and be sarcastic. we in Israel need to be expert at what we do. we don’t put all our diagnostic ‘eggs’ in one basket, as your simplistic view of us seems to think. guess “Me” needs to learn more about the IDF, though he thinks he knows it all. sarcasm intended.

    • SAM

      I am quite sure that his comment was a jab at my comments. I do not believe that he was commenting against IDF. I can accept the jab because we should all be allowed our opinion, weather it is correct or incorrect.

  • Eric Blumensaadt

    True, “compensated shock” presents as elevated heartbeat among other things. This new device PLUS a medic feeling a rapid but thready pulse, clammy skin and the patient’s decreasing ability to respond accurately to questions will back up a standard assessment.

    In field conditions accurate patient assessment is everything. This is another tool to “get it right” and quickly.

  • DBM

    What part of combat triage do you guy not get? People die awaiting care and any device like this can assist the medical people in treating more people with fewer people. Traditionally 1 casualty +’s 3 guys out of the fight. Thats why bouncing betty mines were invented. Not to kill but to wound as many people as possible.

    Is this perfect?No. Is it s tep foreward in saving more lives? Yes


    And how many extra batteries do the medics have to carry with them ? ( I’m being very sarcastic here) I hate the fact that we are relying so much on battery technology for things now instead of learned knowledge and enhanced training.

    Most troops have no idea how to conduct proper land navigation with a map and compass. They continue to become more dependent on GPS. Even the military is getting away from GPS because of the satellite vulnerabilities. We are moving to a accelerometer based devices for everything as not to rely on GPS satellites. Hopefully these new devices will rely on kinetic movement (like watches) to power them and not batteries. Also what happens when the circuit board on this device (which was probably made in China) craps out on you in the desert heat or humidity ?

    I hope that medics don’t rely on this as their only source of triage because it’s the latest whiz-bang toy for the Playstation generation.

    • SAM

      If I had a dollar for every time the BFT or dagger failed, and had the pleasure of laughing at the reactions of those who come to depend on them, who can not think for themselves when the batteries die, I would be very wealthy today. In medicine, dead batteries are not funny, therefore dependancy on batteries is equally life threatening. I will not take something like this on missions. If it transmits a signal, it can help the bad guys find you, it can be hacked, it can fail.