Application of near-infrared spectroscopy to triage of traumatic brain injuries in high-intensity conflicts

On military facilities, triage of traumatic brain injuries (TBI) during the influx of casualties from high- intensity conflicts remains crucial. However, the absence of immediately available CT scan imaging has prevented medical teams from effec-tively screening casualties for immediate surgery or evacuation. 1 Thus, based on our experiences in the field, military neurosurgeon and intensivist provided a training course dedicated to health servicemen in using a near- infrared spectroscopy device to perform triage of TBI. When screening acute intracranial hematomas, near- infrared spectroscopy measures the differences in the haemo-globin levels between extravascular blood and normal brain tissue, previously described and validated by Robertson et al . 2 In this regard, we employed the Infrascanner 2000 (InfraScan, USA), which was designed to detect intracranial hematomas with a volume of >3.5 cc and a depth of <2.5 cm from the surface. This non-invasive optical density (OD) measurement is performed according to four symmet-rical points (frontal, temporal, parietal and occipital), providing results on a digital screen. It displays the results according to each anatomical region, which includes specific OD values and differences, with a green spot indicating locations with OD values of <0.21 (figure 1). Our course, dedicated to military doctors, nurses and medics, consisted of two sequences. The first sequence included a theoretical and practical overview of the device, followed by supervised training in using the device. Approximately 2 weeks later, a second unsupervised sequence was held. In each sequence, the participants performed two sets of measurements. A ‘set’ refers to the four acquisition points