New Device for Treatment of Hemodynamic Shock & Circulatory Arrest
HemaShock® – The Emergency Auto-Transfusion Tourniquet
Emergency Auto-Transfusion Tourniquet – HemaShock® by OHK – is used to squeeze blood out of the legs (also arms if needed) and block reentry of arterial blood flow into those limbs. This can be done quickly by a single caregiver (Paramedic, Medic, Nurse, Physician) even during transport. The HemaShock® is indicated for use in patients who have very low systolic blood pressure (i.e. less than 80 mm Hg) due to Hemodynamic Shock or Circulatory (Cardiac) Arrest.
Exsanguination
Tourniquet –
Auto-Transfusion Tourniquet – HemaShock® by OHK Medical Devices combines two functions:
Note the difference in color between the feet. HemaShock® removes blood (exsanguinates) and blocks it from re-entering (tourniquet)
The time limit for safe use of HemaShock® is 120 minutes
Pathophysiology of Severe Shock
Severe Hemodynamic Shock is characterized by poor tissue perfusion. This results in reduced organ (e.g. brain, heart, kidney, etc.) function and a switch to anaerobic metabolism, acid formation, and loss of arteriolar tone.
When this happens the arterioles and veins dilate and blood pools in the periphery, which further reduces blood pressure and cardiac output.
There are several categories of Shock:
1. Hypovolemic shock where blood volume is lower than normal (blood loss, dehydration, diarrhea (cholera))
2. Distributive shock where the total volume of the circulation is larger than normal (septic, anaphylactic, neurogenic, toxic)
3. Pump failure shock where the heart fails to pump blood into the circulation (cardiogenic)
4. Obstructive shock where blood flow into the right or left ventricles is impeded (cardiac tamponade, pulmonary emboli, pneumothorax)
HemaShock® is indicated for use in severe shock of categories 1 and 2. It is not currently recommended for categories 3 and 4.
The physiological basis and rationale for using HemaShock® during CPR are outlined in the Physiology tab.
W. W. Woodward was the first to report on the use of an HemaShock-like device (Esmach Bandage) to revive a patient in cardiac arrest. It appeared in the Lancet in 1952 (Woodward W.W. Lancet 1952; i: 82). See copy of the original article (right).
Effects of HemaShock® use in normal volunteers on blood pressure and amount of blood displaced from the legs to central circulation.
HemaShock® was kept on each subject for 20 minutes
Information at www.HemaShock.com is intended to educate the international market
It should be noted that HemaShock® is legally marked in the United States and listed with the FDA as a Class I (510(k) exempt) device. Information on the regulatory status of HemaShock® in various countries can be found on the Safety page
The Tutorial on the Instructions tab should be reviewed, in order to understand the application of HemaShock® and its correct removal
Physiological effects of the use of HemaShock® are presented in the Physiology tab in some details. It provides an in-depth understanding of the rationale and basic mechanisms that make HemaShock® beneficial.
Please review the basic study done in normal volunteers and the results. General information on the incorporation of HemaShock® in the treatment of Hemodynamic Shock and in Circulatory Arrest as an adjunct to CPR is provided in the corresponding tabs.
Clinical data including a number of outstanding case reports are provided in the Evidence tab
FAQ
Leg’s tissues can tolerate ischemia for up to 2 hours according to the American College of Surgeons (ACS) guidelines. Visit an orthopaedic OR during TKA and talk to an anaesthesiologist.
It is crucial to remove HS gradually, in phases. Between each phase, monitor patient’s vital signs. Removing it all at once could cause a significant drop in blood pressure, leading to collapse.
Yes, there is no problem to cut the sleeve, as long as it is not removed completely, as it can be necessary to roll down and possibly up again if needed. You can easily push the sleeve up the leg to see the injury with no need to cut it.
No, the maximum period for keeping HS on is 2 hours. In case of more time needed, it is possible to alternate rolling up and down the HS units on the arms and legs (i.e. roll up another pair of HS on both arms -> roll down the HS of one of the legs (allowing its reperfusion) -> roll it up again after a couple of minutes -> roll down the HS of the second leg (allowing its reperfusion) -> roll it up again the second leg after a couple of minutes -> eventually roll down the HS units from the arms)
The goal is to keep patient’s systolic blood pressure between 80 and 100 mmHg, therefore is it is recorded 115 mmHg, the HS should be rolled a bit down, until pressure stabilizes at the desired interval.
1st of all, start CPR.
2nd start AED
3rd apply HemaShock
It will be easier to pull the HS towards yourself when you are positioned on the side of the patient, facing his legs than to push it when you are positioned on the legs facing the face of the patient.
In case the leg remains reddish, remove the HS immediately.