Dr. Keith Gates
Dr. Keith Gates

In the fall of 2010, 3rd Battalion 5th Marines, known as 3/5, deployed to the Sangin Valley in the Helmand province of Afghanistan. The valley, dubbed a death trap for the number of lives its battles have claimed, is surrounded by steep inclines covered in lush green poppy plants. Infamous for their use in the production of heroin, the plants served a second, more strategic purpose in the region – abundant coverage for burying large containers full of powerful homemade bombs, known as improvised explosive devices or IEDs.

Memorial Hermann-Texas Medical Center Emergency Medicine physician and United States Navy Reserve Lt. Dr. Keith Gates, who was serving as a battalion surgeon there at the time, describes these IEDs as a new breed of explosives that were “designed to hit higher, all the way up to the pelvis, rendering a traditional tourniquet useless. Those who were hit would often bleed to death in the field within minutes.”

Gates, who is also an assistant professor of emergency medicine, recognized a gap in medical care of IED injuries and began sketching a new, more versatile tourniquet. His vision became the Junctional Emergency Treatment Tool, or JETT, which recently was selected as one of the Top 20 Innovative Products for 2013 by the EMS World Training Conference.

Applied circumferentially around the body like a belt, the JETT can be tightened around the pelvic region to compress fractures in place and apply inward pressure to the area without impeding respiration. The device also includes two pressure pads that can be positioned directly over the blood vessels supplying the lower extremity, which can be tightened to block blood flow from the femoral arteries of either or both lower limbs, depending on the injury. It is designed to allow for patient movement without dislodging or reducing pressure, which makes it ideal for use in a hostile or pre-hospital environment. Even more, it is compact, lightweight and durable – all necessary components for a device intended to be carried into combat.

Gates worked with Dr. John Holcomb, holder of the Jack H. Mayfield, M.D. Chair in Surgery, chief of the division of Acute Care Surgery and director of the Texas Trauma Institute at Memorial Hermann-Texas Medical Center, to create the prototype and with Dr. Andrew Burgess, professor of orthopaedic surgery and chief of Orthopaedic Trauma Services, to help recreate the injuries on cadavers and test the device. A short 18 months after Gates first sent his sketches from Afghanistan, the JETT was officially FDA approved.

“It was a testament to how well the device worked – and how badly it was needed,” Holcomb said.

The JETT holds incredible promise in the business of saving lives. A limited number already have been deployed in combat in Afghanistan, and it is now carried on all Memorial Hermann Life Flight helicopters. In June, Life Flight nurse-paramedic Rudy Cabrera put the JETT to use on its first civilian patient and it is “without a doubt” the reason one local Houston man is alive today.

– Alexandra Seifert, Memorial Hermann – Texas Medical Center