WO2014174259A1

WO2014174259A1 - Device and method for reducing blood flow from a bullet wound

Info

Publication number: WO2014174259A1
Application number: PCT/GB2014/051223
Authority: WO
Inventors: Charles Kay
Original assignee: 52 Vbl Limited
Priority date: 2013-04-23
Filing date: 2014-04-17
Publication date: 2014-10-30
Also published as: GB201307309D0; GB2513336A

Abstract

A plug for insertion into a bullet wound has a compressible element having an aperture extending therethrough; a shaft passing through the aperture provided in the compressible element; and first and second retaining members positioned on said shaft, such that the compressible element is retained therebetween. The distance between the retaining members is adjustable, so as to alter the extent of compression of the compressible element, and hence control the extent of projection of the compressible element in a lateral direction of the shaft.

Description

DEVICE AND METHOD FOR REDUCING BLOOD FLOW FROM A BULLET WOUND

The present invention relates to devices and methods for plugging a bullet wound, so as to reduce blood flow therefrom, in particular to devices that are configured to be expandable after insertion into a bullet wound, so as to exert pressure against the internal surfaces of the bullet wound.

In the event of a bullet wound being sustained, there is an immediate need to stabilise the casualty by stemming blood flow to avoid a catastrophic reduction in blood pressure and consequent damage to the casualty's internal organs. This helps to avoid deterioration in the state of the casualty until the time when further medical help becomes available.

The current methods that are used to achieve this objective include the use of compression bandages and/or the application of external pressure upon the wound by a third party. Both these methods are time-consuming and require high levels of manpower. Additionally, both methods tend to result in pressure being applied broadly around the site of the bullet wound, rather than specifically at the bullet wound itself.

Therefore, there is a need to provide more effective and targeted means for stemming blood flow from a bullet wound, to stabilise the casualty until further medical attention becomes available.

At its most general, the present invention may provide a plug whose lateral dimensions are adjustable. That is, the plug is movable between a first, retracted configuration, which allows the plug to be inserted into a bullet wound, and a second, expanded configuration, which allows the plug to press against the internal surface of the bullet wound, thus stemming blood flow from the wound. In a first aspect, the present invention may provide a plug for insertion into a bullet wound, the plug comprising:

• a compressible element having an aperture extending therethrough;

• a shaft passing through the aperture provided in the compressible element;

• first and second retaining members positioned on said shaft, such that the compressible element is retained therebetween;

wherein the distance between the retaining members is adjustable, so as to alter the extent of compression of the compressible element, and hence control the extent of projection of the compressible element in a lateral direction of the shaft.

The plug is configured such that, as the distance between the retaining members is decreased, the extent of compression of the compressible element is increased, and consequently, the extent of projection of the compressible element in a lateral direction of the shaft is also increased. Conversely, as the distance between the retaining members is increased, the extent of compression of the compressible element is decreased, and consequently, the extent of projection of the compressible element in a lateral direction of the shaft is also decreased.

Effectively, the plug becomes broader as the distance between the retaining members is decreased, thus allowing it to press against the internal surface of a bullet wound and help to stem blood flow. Conversely, the plug becomes thinner as the distance between the retaining members is increased, thus allowing it to be inserted into, or removed from the bullet wound in a controlled manner.

Typically, the compressible element comprises a plurality of flexible and resilient elongate elements, each elongate element being attached at one end to a first collar and at the other end to a second collar, such that the elongate elements are caused to bow outwardly when the first and second collars are pushed together, The compressible element may comprise e.g. three or more of these elongate elements.

The second collar and the second retaining member may be provided by the same component.

Preferably, one end of the plug is provided with an anchoring member that comprises one or more elements that extend outwardly from the shaft in a lateral direction of the shaft, the anchoring member being for controlling the depth of insertion of the plug into the bullet wound. The anchoring member is configured to lie against the casualty's skin when the plug has been inserted into the wound.

Typically, in the case that the compressible element comprises first and second collars, the anchoring member is positioned between the first collar and the first retaining member. In certain cases, the anchoring member may be attached to the first collar (for example, it may be integrally formed with the first collar). Alternatively, the anchoring member may simply abut the first collar. The latter configuration may allow the anchoring member to be separated from the plug, which may be desirable in cases where the entry wound to be plugged is at an oblique angle to the skin surface.

Preferably, the anchoring member is provided by a plate having an aperture that receives the shaft. The plate may be formed from a flexible material. In certain cases, the plate may have a curved shape (that is, the plate has a concave side and a convex side) and may be oriented such that the concave side of the plate faces towards the compressible element. These features may help to ensure that the plate lies flush against the casualty's skin. Preferably, the surface of the plate that faces away from the compressible element is textured or provided with grips. This may allow the person manipulating the plug to obtain improved grip against the plate.

In general, the first retaining member is fixed in position relative to the shaft, while the second retaining member is movable relative to the shaft. Embodiments of the invention are also possible in which both retaining members are movable relative to the shaft, but these are less preferred.

Typically, the first retaining member is integrally formed with the shaft. For example, the first retaining member may comprise a ridge extending around the shaft.

Typically, the second retaining member is in threaded engagement with the shaft. Thus, the position of the second retaining member along the length of the shaft may be adjusted by turning the shaft relative to the second retaining member.

In general, the shaft is provided with a grip to facilitate this rotation of the shaft. Typically, the extent of projection of the grip in a lateral direction of the shaft is greater than the radius of the shaft, so as to provide the person manipulating the plug with mechanical advantage.

Preferably, the grip is hingedly connected to the shaft, such that the grip is movable from a first position, in which it projects outwardly from the shaft, to a second position, in which it is folded against the shaft. Typically, the grip is moved to the first position when the shaft is to be rotated, and it is folded away once rotation is complete, in order to reduce the risk of the grip catching against other objects.

In other, less preferred embodiments, the grip may be integrally formed with the shaft. Typically, the plug has an insertion end and a protruding end, the insertion end having a tapered shape to facilitate insertion into the wound. The protruding end corresponds to the portion of the plug that protrudes from the casualty's body once the plug has been inserted into the wound and may comprise e.g. the first retaining member, the anchoring element and/or the grip.

The insertion end of the plug may comprise a hollow tapered portion for accommodating an end of the shaft. The hollow tapered portion may be integrally formed with the second retaining member. In the case that the second retaining member and the second collar are provided by the same component, the hollow tapered portion may be integrally formed with the second collar.

Preferably, the plug is provided with a sheath that covers at least the compressible element. Such a sheath may help to give the plug a smooth outer surface, so as to facilitate insertion of the plug into the wound. The outer surface of the sheath may be textured in order to assist in gripping against the inner surface of the wound. Additionally, the outer surface of the sheath may be provided with a lubricant and/or anti-bacterial agent and/or local anaesthetic.

In general, the sheath has an elongate shape, having an aperture at one end only.

Preferably, the aperture has a thickened rim and the plug is provided with a channel extending around its longitudinal axis, the channel being adapted to receive the rim. This helps to secure the sheath onto the plug. Although the channel extends generally around the longitudinal axis of the shaft, it is not necessarily provided within the shaft itself. For example, the channel may be provided within the first collar.

In general, the plug is configured such that the maximum width of the compressible element, measured in the lateral direction of the shaft is capable of being varied from a value of below 6 mm to a value of over 8 mm. For reference, a standard NATO bullet has a diameter of 5.56 mm.

Typically, the plug is stored before use in a sterile, sealed packet. The packet may contain a dye that can be used to mark the casualty's skin, to show that a plug has been inserted. Such a dye may be incorporated into e.g. a lubricant, an anti-bacterial agent, or a local anaesthetic.

In a second aspect the present invention may provide a kit for assembly into a plug according to the first aspect of the invention, the kit comprising:

• a shaft;

• a compressible element having an aperture for receiving the shaft;

• a first retaining member that is either positioned on the shaft or adapted to be mounted on the shaft;

• a second retaining member that is adapted to be mounted on the shaft, the first and second retaining members being adapted to retain the compressible element therebetween along the shaft,

wherein the second retaining member is optionally joined to the compressible element.

The kit is typically assembled by passing the shaft through the compressible element and mounting the second retaining member on the shaft. In the case that the first retaining member is not already positioned on the shaft, it must also be mounted on the shaft.

Typically, the kit further comprises a sheath for covering at least the compressible element. In use, the plug according to the first aspect of the invention is inserted into a bullet wound and then the compressible element is caused to expand laterally, so as to press against the internal surface of the wound.

Therefore, in a third aspect, the present invention may provide a method of limiting blood flow from a bullet wound, comprising the steps of:

• inserting a plug according to the first aspect of the invention into a bullet wound; and

• causing the distance between the first and second retaining members to be reduced, such that the extent of projection of the compressible element in a lateral direction of the shaft is increased.

Effectively, the plug is inserted into the bullet wound in a retracted configuration, and then caused to move into an expanded configuration. The plug can then be removed from the wound by causing the distance between the first and second retaining members to be increased, so as to reduce the extent of projection of the compressible element in a lateral direction of the shaft. That is, the plug is effectively returned to its retracted configuration.

The invention will now be described by way of example with reference to the following Figures in which:

Figure 1 is a schematic section view of a plug according to the first aspect of the invention, shown in its retracted configuration (for simplicity, the covering sheath is not shown);

Figure 2 is a schematic section view of a plug according to the first aspect of the invention, shown in its deployed configuration;

Figure 3 is a plan view of the plug of Figure 1 ;

Figure 4 is a side view of the plug of Figure 1 , showing the covering sheath. Referring to Figures 1-4, a plug 10 comprises a shaft 12, a compression piece 14 and a sheath 16.

The compression piece 14 comprises an anchoring plate 18 that has a circular outer perimeter and a central aperture. The anchoring plate is typically made from a flexible polymer such as rubber or silicone. The anchoring plate 18 has a curved shape and a first collar 20 is provided on the concave side of the plate, around the central aperture. The convex side of the anchoring plate is textured and/or comprises recesses to provide means for a user to exert a grip on the surface of the anchoring plate. The convex side of the anchoring plate may further display printed or engraved directions for the use of the plug. A channel 22 extends around the outer surface of the first collar 20.

The compression piece 14 comprises a second collar 24 that is connected to the first collar 20 by means of a compressible element 26 comprising plurality of flexible and resilient elongate parts (typically, three or four such parts are provided). Each elongate part is attached at one end to the first collar 20 and at the other end to the second collar 24. The elongate parts each bow outwardly between the two collars 20,24, such that the effective diameter of the compressible element increases progressively from each of the collars to the mid-point of the elongate parts. The maximum effective diameter of the compressible element 26 is represented by the letter A in Figure 1.

The second collar is integrally formed with a hollow tapered element 28, the hollow tapered element being shaped such that it tapers in a direction away from the first collar 20, to provide a rounded nose for the compression piece 14.

The second collar 24 is provided with a screw thread on its internal surface. The shaft 12 is provided with a grip 30 at one end. The grip 30 is a planar element that is hingedly connected to the body of the shaft, such that it is movable from a first position (shown in Figures 1 , 2 and 4) in which it is aligned with the longitudinal axis of the shaft, to a second position (shown in Figure 3) in which it is folded against the end surface of the shaft.

The end of the shaft adjacent the grip 30 is shaped to provide a ridge 32 extending around the perimeter of the shaft. The end of the shaft distal from the grip 30 is provided with a screw thread extending around its outer surface.

The shaft 12 passes through the aperture in the anchoring plate, the first collar 20 and the second collar 24, such that the ridge 32 abuts the convex side of the anchoring plate 18 and the screw thread of the shaft engages with the screw thread of the second collar 24.

The sheath 16 has an elongate shape and a single aperture at one end. The rim of the sheath extending around the aperture is thickened with respect to the remainder of the sheath. The sheath 16 covers the hollow tapered element 28 and the compressible element 26. The thickened rim 16a of the sheath is received in the channel 22 provided around the first collar 20. The sheath is typically manufactured from silicone or rubber. The outer surface of the sheath may be textured to increase grip against the inner surface of a bullet wound. Additionally, the outer surface of the sheath may be treated with a lubricant and/or anti-bacterial substance and/or local anaesthetic.

In use, the plug 10 is unwrapped from a sterile, sealed package and inserted into a bullet wound, the hollow tapered end of the compression piece 14 (covered by the sheath 16) entering the wound ahead of the rest of the plug. The plug is brought to a rest position in which the anchoring plate 18 rests against the casualty's skin. The grip 30 is brought to its first position and used to turn the shaft 12, such that the threaded engagement between the shaft 12 and the second collar 24 causes the second collar to move in the direction of the grip 30 (the correct direction of rotation of the shaft may be shown through printed or engraved directions on the convex surface of the anchoring plate 18). The movement of the first collar 20 is constrained by the fact that the anchoring plate 18 abuts against the ridge 32 provided at the end of the shaft 12. Thus, the elongate parts are caused to bow in an outward direction of the shaft, so as to press the sheath 16 against the internal walls of the wound and reduce blood flow from the wound. This configuration is shown in Figure 2. The grip 30 is then moved to its second position, so that it no longer protrudes from the casualty's body. This reduces the risk of snagging of the plug against external objects.

To remove the plug, the grip 30 is returned to its first position and rotated so as to cause the second collar 24 to move away from the grip 30. The resilient nature of the elongate parts causes their extent of curvature to be reduced, such that they no longer press against the internal walls of the bullet wound. This configuration is shown in Figures 1 and 4. Thus, the effective diameter of the portion of the plug inside the wound is reduced and the plug can be extracted from the wound.

Through this method, the maximum effective diameter of the compressible element 26 may be increased from about 5.56 mm (the diameter of a standard NATO round) to about 9 mm.

Claims

1. A plug for insertion into a bullet wound, the plug comprising:

• a compressible element having an aperture extending therethrough;

• a shaft passing through the aperture provided in the compressible element;

2. A plug according to claim 1 , wherein the compressible element comprises a plurality of flexible and resilient elongate elements, each elongate element being attached at one end to a first collar and at the other end to a second collar, such that the elongate elements are caused to bow outwardly when the first and second collars are pushed together.

3. A plug according to claim 2, wherein the compressible element comprises at least three elongate elements.

4. A plug according to claim 2 or claim 3, wherein the second collar is provided by the second retaining member.

5. A plug according to any one of claims 2-4, wherein the first collar is attached to an anchoring member that comprises one or more elements that extend outwardly from the shaft in a lateral direction of the shaft, the anchoring member being for controlling the depth of insertion of the plug into the bullet wound.

6. A plug according to any one of the preceding claims, wherein one end of the plug is provided with an anchoring member that comprises one or more elements that extend outwardly from the shaft in a lateral direction of the shaft, the anchoring member being for controlling the depth of insertion of the plug into the bullet wound.

7. A plug according to claim 6, wherein the anchoring member is provided by a plate having an aperture that receives the shaft.

8. A plug according to claim 7, wherein the plate has a curved shape and the concave side of the plate faces towards the compressible element.

9. A plug according to claim 7 or claim 8, wherein the surface of the plate that faces away from the compressible element is textured or provided with grips.

10. A plug according to any one of the preceding claims, wherein the first retaining member is fixed in position relative to the shaft.

1 1. A plug according to claim 10, wherein the first retaining member is integrally formed with the shaft.

12. A plug according to any one of the preceding claims, wherein the second retaining member is movable relative to the shaft.

13. A plug according to claim 12, wherein the second retaining member is in threaded engagement with the shaft.

14. A plug according to claim 13, wherein the shaft is provided with a grip to facilitate rotation of the shaft.

15. A plug according to claim 14, wherein the extent of projection of the grip in a lateral direction of the shaft is greater than the radius of the shaft.

16. A plug according to claim 14 or claim 15, wherein the grip is hingedly connected to the shaft, such that the grip is movable from a first position, in which it projects outwardly from the shaft, to a second position, in which it is folded against the shaft.

17. A plug according to claim 16, wherein the plug is provided with a recess for receiving the grip when it is in the second position.

18. A plug according to claim 14 or claim 15, in which the grip is integrally formed with the shaft.

19. A plug according to any one of the preceding claims, wherein the plug has an

insertion end and a protruding end, the insertion end having a tapered shape to facilitate insertion into the wound.

20. A plug according to claim 19, wherein the second retaining member comprises a hollow tapered portion for accommodating an end of the shaft.

21. A plug according to any one of the preceding claims, further comprising a sheath that covers at least the compressible element.

22. A plug according to claim 21 , wherein the sheath has a thickened rim, and wherein the plug is further provided with a channel extending around the longitudinal axis of the plug, the channel being adapted to receive the rim.

23. A plug according to claim 21 or claim 22, wherein the outer surface of the sheath is textured.

24. A plug according to any one of claims 21-23, wherein the outer surface of the sheath is provided with a lubricant and/or an anti-bacterial agent and/or local anaesthetic.

25. A plug according to any one of the preceding claims, wherein the maximum width of the compressible element, measured in the lateral direction of the shaft is capable of being varied from a value of below 6 mm to a value of over 8 mm.

26. A kit for assembly into a plug according to any one of the preceding claims, the kit comprising:

• a shaft;

• a compressible element having an aperture for receiving the shaft;

wherein the second retaining member is optionally connected to the compressible element.

27. A method of limiting blood flow from a bullet wound, comprising the steps of:

• inserting a plug according to any one of claims 1-25 into a bullet wound; and