title: Focused ultrasound: concept for automated transcutaneous control of hemorrhage in austere settings.
abstract: BACKGROUND
  High intensity focused ultrasound (HIFU) is being developed for a range of clinical applications. Of particular interest to NASA and the military is the use of HIFU for traumatic injuries because HIFU has the unique ability to transcutaneously stop bleeding. Automation of this technology would make possible its use in remote, austere settings by personnel not specialized in medical ultrasound. Here a system to automatically detect and target bleeding is tested and reported.
  
  
  METHODS
  The system uses Doppler ultrasound images from a clinical ultrasound scanner for bleeding detection and hardware for HIFU therapy. The system was tested using a moving string to simulate blood flow and targeting was visualized by Schlieren imaging to show the focusing of the HIFU acoustic waves.
  
  
  RESULTS
  When instructed by the operator, a Doppler ultrasound image is acquired and processed to detect and localize the moving string, and the focus of the HIFU array is electronically adjusted to target the string. Precise and accurate targeting was verified in the Schlieren images.
  
  
  CONCLUSIONS
  An automated system to detect and target simulated bleeding has been built and tested. The system could be combined with existing algorithms to detect, target, and treat clinical bleeding.
authors.affiliation: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA 98105-6698, USA. kucewicz@u.washington.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Kucewicz
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bailey
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kaczkowski
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Carter
mesh_terms: D004867:Equipment Design; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008889:Military Personnel; D013026:Space Flight; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D018615:Ultrasonography, Doppler, Color