Treatment for high pressure bleeding

Abstract

High-pressure bleeding wounds (and other bleeding wounds) may be treated by applying direct pressure directly in the bleeding wound, such as by applying a back pressure in a confined space around and in the wound. Certain substances and articles may be inserted into the wound, and the wound may be enclosed with that substance or article (such as a hemostatic substance, which may be polymeric), by swelling on contact with molecules (such as water molecules in the blood) encountered in the wound, generates the desired pressure to stop or at least reduce the bleeding without the detrimental effects of a tourniquet. Clot-inducing substances may be introduced into the wound contemporaneously with direct pressure application directly in the wound. Compressible and non-compressible wounds are treated. Treatment stops bleeding without producing pressure injury or ischemic damage. Medical devices using this technology are provided, including removable, biodegradable, medic-administrable devices.

1 - 39 . (canceled) 
     
     
         40 . A medical device comprising a hemostatic substance placeable directly in a bleeding wound, wherein the wound is a compressible wound or a non-compressible wound. 
     
     
         41 . The device of  claim 40 , wherein the wound is a battlefield injury. 
     
     
         42 . The device of  claim 40 , wherein the bleeding is high pressure bleeding. 
     
     
         43 . The device of  claim 40 , wherein the device stops bleeding at bleeding pressures of up to about 60 to 90 mm Hg. 
     
     
         44 . The device of  claim 40 , wherein the device is removable. 
     
     
         45 . The device of  claim 40 , wherein the device is biodegradable. 
     
     
         46 . The device of  claim 40 , wherein the device when placed in a bleeding wound swells at a rate of about 100 to 300%) volume increase per minute. 
     
     
         47 . The device of  claim 40 , wherein the device produces pressure of greater than about 60 mm Hg in a confined space. 
     
     
         48 . The device of  claim 40 , wherein the device is administrable by a medic. 
     
     
         49 . A medical device comprising a back-pressure generator placeable directly in a bleeding wound. 
     
     
         50 . The device of  claim 49 , wherein the back-pressure generator comprises a hemostatic substance or article. 
     
     
         51 . The device of  claim 49 , wherein the back-pressure generator comprises polymer fibers of diameter about 1 micron or less. 
     
     
         52 . The device of  claim 49 , wherein the back-pressure generator swells upon contact with water molecules. 
     
     
         53 . The device of  claim 49 , wherein the back-pressure generator swells upon contact with blood. 
     
     
         54 . The device of  claim 49 , wherein the back-pressure generator comprises a lightly cross-linked material. 
     
     
         55 . The device of  claim 49 , wherein the back-pressure generator absorbs at least 10 times its weight of water. 
     
     
         56 . The device of  claim 49 , including a membrane enclosing an interior hemostatic substance or article. 
     
     
         57 . The device of  claim 56 , wherein the membrane stiffens as the interior hemostatic substance or article swells. 
     
     
         58 . The device of  claim 49 , wherein the back-pressure generator swells from an initial volume to a 10-fold volume in one minute in a liquid. 
     
     
         59 . The device of  claim 49 , including a polymeric substance. 
     
     
         60 . The device of  claim 49 , including a microporous, hydrogel-forming polymer with rapid swelling kinetics. 
     
     
         61 . The device of  claim 49 , including poly(acrylamide) and/or hydroxypropylcellulose. 
     
     
         62 . The device of  claim 49 , including a flexible, highly porous membrane. 
     
     
         63 . The device of  claim 49 , including a substance that swells at a rate of 100 to 300% volume increase per minute. 
     
     
         64 . The device of  claim 49 , including a clot-inducing substance. 
     
     
         65 . The device of  claim 49 , including thrombin, batroxobin, reptilase, or a fibrinogen activating enzyme. 
     
     
         66 . The device of  claim 49 , including a substance that swells at a rate of 100 to 300%) volume increase per minute and a clot-inducing substance. 
     
     
         67 . The device of  claim 49 , wherein the back-pressure generator provides a pressure in the range of about 50 to 90 mm Hg. 
     
     
         68 . The device of  claim 49 , including an elastic hemocompatible shell and at least one antibiotic and/or analgesic within the shell. 
     
     
         69 . The device of  claim 49 , including a bladder within a porous membrane. 
     
     
         70 . The device of  claim 49 , including an impermeable inflatable bladder within a porous membrane. 
     
     
         71 - 75 . (canceled)