Electronic Military & Defense Annual Resource

4th Edition

Electronic Military & Defense magazine was developed for engineers, program managers, project managers, and those involved in the design and development of electronic and electro-optic systems for military, defense, and aerospace applications.

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Technology Electronic Military & Defense Annual Resource, 4th Edition 9 Current Mobile Planar Imaging Options The current generation of mobile X-ray sources relies on compact packaging of conventional X-ray sources. Increasingly portable X-ray sources are also used in hospital settings in an attempt to provide superior in-patient care, and represent ~15 percent (and growing) of the market for planar radiology. These devices typically weigh from 200 to 300 kg, have a footprint of approximately one square meter, and cost up to $250,000 (list price to the hospital). The size and weight are largely a function of the X-ray source, attendant high voltage power supply, and thermal management equipment — for example, of the 285 kg weight of a Siemens Mobilett, 4.8 kg is the detector, another few kg is the weight of the laptop computer used as an acquisition workstation, and the remainder (>270 kg) is the source. Most of the weight comprises the battery and power supply. In military and field applications, weight and robustness are paramount. An example of currently available X-ray imaging systems is the MinXray MXRSLW Military X-Ray System that weighs (system and stand) 43.8 kg with a shipping weight (complete system weight in case) of 100.6 kg. Beyond the critical demands on image quality, there are a number of factors that determine the clinical utility of an X-ray imaging system. However, the current gen- eration of devices offers only a limited range of options due to the inherent size, weight, and profile of the X-ray source. Benefits Of Portability For The Warfighter A lightweight and portable X-ray device would enable injured soldiers to be directly imaged at a forward operating base (FOB) or at the site they are wounded in the case of critically wounded soldiers, which would translate into the following benefits: 1. Critically injured soldiers can have the correct placement of artificial breathing tubes (intubation) to ensure that the airway will sustain life until the casualty arrives at a field hospital. 2. Severely injured soldiers can have injuries imaged such that radiologists can read the scans using teleradiology before the casualty arrives at the field hospital, potentially compressing clinical workflow by allowing correct equipment and personnel to be waiting for the wounded soldier on arrival at the field hospital. 3. Disease nonbattle injuries (DNBI) could be imaged by generalist military medical staff in the FOBs and read remotely using teleradiology or locally, to achieve the following outcomes: • Soldiers who have minor open wounds could be imaged to ensure that there are no foreign bodies, allowing the wound to be managed without evacuation — saving helicopter hours, weight, and the risks associated with helicopter travel in combat zones. • Soldiers who sustain musculoskeletal nonbattle injuries (e.g., lower leg injuries were prevalent in Afghanistan due to the combination of equipment, weight, and terrain) can be assessed in the FOB to identify if the injury requires them to be withdrawn from operations or simply left at the FOB to rest. This will reduce either time waiting to be ruled out of service or the alternative costs and risks of helicopter transfer to a field hospital for imaging and subsequent return if the soldier is declared fit. It also means that appropriate treatment can commence earlier. The key benefit of the use of this technology in DNBI is to act as a force multiplier by reducing unnecessary helicopter hours and increasing operational availability of soldiers. Potentially, X-ray imaging could assist in triage decisions that affect whether helicopter assets are placed at risk. As indicated above, one key benefit of the use of this technology in DNBI is to act as a force multiplier by reducing unnecessary helicopter hours and increasing operational availability of soldiers. Cargo weight for combat health support (CHS) radiological operations can be nearly 1,000 pounds and is of considerable importance. The overall breadbox size and weight of a fully digital imaging system using the flat-panel technology (less than one cubic foot and under 20 kg) are an order of magnitude smaller than any comparable high-energy X-ray device. An overview of the most important applicable military emergency situations for which portable imaging could provide useful and instrumental information for the medical team before transportation Acquisition Clinical rationale / indications Chest (patient lying on back) To diagnose air trapped next to the lung (pneumothorax) and blood trapped next to the lung (hemothorax) All extremities To identify long bone fracture Pelvis (patient lying on back) To diagnose unstable pelvic fracture Abdomen (patient lying on back) To aid diagnosis of acute abdomen Chest (patient lying on back) To identify correct breathing tube (endotracheal tube) or central venous catheter positions Table 1: Types of X-ray imaging relevant in a field setting (includes both trauma and medical emergencies).

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