A bicycle inner tube? Where were we on this? Well to continue the story, in 2009 Drs. Mark Hauswald, Nancy Kerr and colleagues published in the International Journal of Emergency Medicine. Their findings were on an improvised pneumatic anti-shock garment. At that stage, the device was three inner tubes, one around each leg and one around the pelvic area. The tubes were pumped up to 45 psi. They found that both the improvised (bike tire) device and the non-pneumatic anti shock garment decreased distal aortic blood flow but that the improvised device decreased it by a higher margin.
As you can see in the photo above, the team has progressed rapidly. Fast forward to today where the team has a Saving Lives at Birth grant securely under their 'belts' and is piloting the project in Nepal. The training and pilot took place over 8 months and the midwives who were trained all still have their devices at the ready in their villages. Hauswald notes that the Nepali midwives are well-trained and very, very opinionated. This will ultimately result in a long development process but a much better end product. At present it is sewn with a (kelly green) bedsheet and bicycle inner tubes that could be manufactured inexpensively almost anywhere.
Though training and use of the device is going well, Hauswald and team want to do a trial in a community hospital next. He points out that if this is seen as a 'smart, modern solution' useful in hospital settings, it will the be better accepted by midwives and nurses in non-facility settings and by higher level policymakers. He would also like to another trial in another setting and another culture.
In the course of our conversation, Dr. Hauswald also mentioned the use of a 'soccer' or football or a knee (yes, knee) to exert pressure and counter arterial bleeding. As he said, 'you need to do what the marines do in the field.'
We'll keep you posted on the next steps in this exciting development in the battle against maternal mortality.