Mission Magazine - Fast solution to collapsed veins developed in UTHSC-private partnership

Fast solution to collapsed veins developed in UTHSC-private partnership

August 2003

by Will Sansom

A jogger falls with a heart attack … a soldier is hit by mortar fire … a driver is crushed inside a car. As they go into shock their veins collapse, making a traditional IV very difficult to start. Without a rapid infusion of fluids, blood or medicines, they are likely to die. When seconds count, a medical device that can shave minutes off the start of therapy would save thousands of these patients each year.

Just such a device, the VidaPort, was recently unveiled at the Health Science Center. The handheld VidaPort was conceived and developed by emergency medicine physician Larry J. Miller, M.D., in conjunction with researchers at the Health Science Center. Dr. Miller is chairman and chief executive officer of VidaCare Corp. of San Antonio.

"As the nation continues to be in a state of vigilance for potential acts of terrorism, more is required of our first responders," said Francisco G. Cigarroa, M.D., president of the Health Science Center. "When minutes and seconds matter, they need every tool they can get." Dr. Cigarroa announced the university has entered its first equity agreement in lieu of royalties with VidaCare, which is developing and marketing the product worldwide. "This is a great example of how the Health Science Center works with the community to develop intellectual property," Dr. Cigarroa said.

The medical community years ago established the effectiveness of administering blood transfusions, medicines and fluids through the bone marrow for infants who have collapsed veins due to shock. Until recently there has been no solution for adults because their bones are too hard to access the bone marrow, which has been called a non-collapsible vein. VidaPort, which drills a small needle through the bone to the marrow cavity, is expected to revolutionize a technique called intraosseous (IO) vascular access.

00:00:00
Medic identifies shin bone on the leg

00:00:03
Needle is placed on shin bone and a small driver inserts the hollow needle into target area in less than 5 seconds

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VidaPort driver is removed from needle

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Syringe is attached to give lifesaving IV medications

"This is a critically needed technology that will save thousands of lives a year," Dr. Miller said. "This technology and the science behind it will alter the standard of patient care throughout the world. It also solves a particular problem for our military. Medics in Special Operations generally operate at night. Most patients in such a theater have suffered life-threatening trauma. A study shows that on the average it takes a medic 12 minutes to start an IV. Lives are lost during that time because of the delay. Thanks to VidaPort, starting a line will take less than 20 seconds."

Dr. Miller was chairman of emergency medicine at the Baptist Health System hospitals in San Antonio until September 2002, and has 30 years of experience as an emergency medicine physician.

Emphasis on homeland security is sure to make the VidaPort a timely weapon in combating the effects of terrorism. The threat of mass exposures to biological weapons such as anthrax makes finding a quick, reliable way to start fluids and medications even more essential, said Harold L. Timboe, M.D., M.P.H., vice president for administration and director of the Center for Public Health Preparedness and Biomedical Research at the Health Science Center. "In a situation involving mass casualties, paramedics and other first responders will need this new technology," said Dr. Timboe, former commander of Brooke Army Medical Center and Walter Reed Army Medical Center.

September 11 spurred emergency health professionals to talk more seriously about mass casualty situations, agreed Scott Bolleter, a veteran flight paramedic for AirLife. "The problem is how do we treat that many people in a life-threatening situation? This device will allow access and treatment in seconds, compared to what normally would take minutes. If you’re talking about keeping Americans alive in a potentially devastating event, this is a key development. In the hands of the right people in civilian pre-hospital medicine and the military, this will save many, many lives."

The devices used in children are inserted manually. The VidaPort will come with an analgesic agent (lidocaine) to numb the area to the bone 30 seconds before insertion. The device can be inserted into the tibia (the shin bone) or arm. Most recipients would be suffering from shock or unconscious.

VidaCare and the Health Science Center have completed preclinical trials and are in the process of filing for a 510k approval with the U.S. Food and Drug Administration. The 510k approval, generally a 90-day process, would clear the VidaPort for use in humans. Once it hits the market, the VidaPort driver is expected to sell for about $150 and the replaceable needles for about $95.

"From a field provider’s perspective, this is going to be less difficult to use than the devices currently available for children," Bolleter said. "The VidaPort is far and above those devices in its ability to deliver fluids to the site we need to access. Clearly if the patient is in a life-threatening situation, this is an absolute no-brainer. There have been quite a few situations in the last few weeks when we really wished we would have had it."

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Updated 5/17/12

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