Early, accurate identification of intracranial bleeding is critical in the management of traumatic brain injuries, especially in pre-hospital, rural, or resource-limited settings where advanced imaging may not be readily available. In these scenarios, a rapid, non-invasive method to assess whether a patient may have a subdural or epidural hematoma can be invaluable.
Near-Infrared Diffuse Reflectance (NIRD) is a scientific approach that uses near-infrared light to evaluate changes in hemoglobin concentration beneath the surface of biological tissue. It builds on the broader principles of near-infrared spectroscopy but is designed specifically to detect structural anomalies, such as asymmetrical patterns of hemoglobin that may signal a brain bleed.
ArcheOptix’s NIRD® device applies this method in a portable, field-ready tool. Built for emergency responders and frontline clinicians, it brings the science of diffuse reflectance to point-of-care triage, delivering critical insight in just minutes.
This blog explores the scientific foundation of Near-Infrared Diffuse Reflectance, how the NIRD® device uses it, what it measures, and how it supports faster, more informed decision-making in time-sensitive environments.
What Is Near-Infrared Diffuse Reflectance, and How Does the NIRD® Device Use It?
Near-Infrared Diffuse Reflectance is a non-invasive optical technique that uses near-infrared light to assess changes in hemoglobin concentration within the brain. ArcheOptix’s NIRD® device applies this principle to brain trauma assessment by focusing on two critical diagnostic markers:
1. Hemoglobin Concentration Differences
The NIRD® device exploits the differing absorption properties of oxygenated (HbO₂) and deoxygenated hemoglobin (Hb). By sending near-infrared light through the skull and analyzing the reflected signal, the device detects regional changes in blood content and oxygenation. In the presence of a bleed, these concentrations shift, revealing anomalies that might otherwise go unnoticed in the early phase of trauma.
2. Symmetry and Anomalies
A healthy brain exhibits fairly symmetrical hemoglobin distribution across hemispheres. Acute subdural or epidural hematomas often create asymmetries, with pooled blood altering the absorption of light in one region more than the other. The NIRD® device analyzes these left-right variances in real-time, offering a clear indication of abnormal findings without delay.
The result: a non-invasive scan that flags abnormalities where it counts: at the scene, not after transport.
How the NIRD® Device Differentiates Normal vs. Life-Threatening Findings
What makes the NIRD® device particularly useful in the field is its ability to screen out normal cases while prioritizing those with urgent findings. This is achieved through advanced signal processing and algorithms that analyze:
- Hemoglobin concentration shifts
- Rate and degree of light absorption
- Bilateral discrepancies across the brain’s surface
In practical terms:
- A normal scan shows balance and consistency
- A positive indication for a hematoma appears as significant asymmetry, high deoxygenated hemoglobin, or other patterns consistent with bleeding
The NIRD® device doesn’t generate an image like a CT scan, but it tells the clinician what they need to know most: Is there likely bleeding? Should this patient be escalated immediately?
How Near-Infrared Diffuse Reflectance Compares to CT Imaging
CT scans remain the gold standard for imaging brain injuries, but they come with notable limitations, especially in the field. The NIRD® device offers a complementary solution by providing:
- 95–98% sensitivity in identifying acute subdural and epidural hematomas
- High specificity, with minimal false positives
- Fast, actionable data when CT is unavailable or delayed
The NIRD® device is not intended to replace CT imaging. Instead, it fills the gap between initial injury and imaging access, helping prioritize the right patients for immediate transport, while potentially sparing others unnecessary transfers or radiation exposure. In mass casualty incidents or rural medicine, this distinction becomes critically important.
Why the NIRD® Device Is Ideal for Field Conditions
Designed specifically for emergency and prehospital use, the NIRD® device is tailored to work where CT and MRI cannot.
Field-Friendly Features:
- Portable (8.5 lbs): Lightweight and compact for ambulances, helicopters, or disaster sites
- No prep required: No gels, no scalp shaving, and no calibration, just place and scan
- Battery powered: Fully functional in power-scarce or mobile environments
- Safe for repeated use: Radiation-free and non-invasive
- Fast results: Data in minutes, often before transport is even underway
This makes it a powerful asset for EMS crews, military medics, and rural care providers tasked with making urgent triage decisions on-site.
Complementing (Not Replacing) Clinical Judgment
The NIRD® device is not intended to replace clinical assessment, but rather to support it by providing additional data to inform decision-making in the field.
How It Supports Medical Decision-Making:
- Adds a data layer to observational tools like GCS or neurological checks
- Confirms or questions initial assessments based on objective metrics
- Helps in ambiguous cases where symptoms are unclear or delayed
- Prioritizes resources by identifying the most critical patients
For EMS professionals, nurses, and physicians, the NIRD® device offers an added layer of information, helping to confirm clinical impressions and guide timely decisions when every minute counts.
Field Scenario: Rural EMS Response
Here is a common scenario: A volunteer paramedic team in a rural township is called to a roadside incident. The patient is alert but disoriented and has a visible scalp contusion. The nearest imaging facility is two hours away.
The EMS crew deploys the NIRD® device:
- It detects asymmetrical reflectance in the left hemisphere, consistent with an acute subdural bleed.
- The crew initiates immediate trauma transport, alerting the receiving hospital en route.
- Air medevac is activated, bypassing unnecessary local hospital delays.
In this case, the NIRD® device confirmed the urgency of care and supported the team’s clinical judgment all within minutes.
Why This Technology Matters More Than Ever
Brain trauma remains one of the leading causes of disability and death in emergency medicine. Inconsistent access to diagnostics, rural inequities, and transport delays continue to put patients at risk.
The NIRD® device helps close that gap. It transforms how providers can respond to trauma in the field by offering CT-level diagnostic confidence at the point of care without the bulk, cost, or radiation.
From sports injuries to battlefield medicine, remote clinics to EMS, this technology helps clinicians:
- Save time
- Make smarter transport decisions
- Reduce resource strain
- Improve patient outcomes
Science in Service of Speed and Accuracy
The NIRD® device is grounded in proven science and built around the practical needs of emergency medicine. For those on the front lines like physicians, medics, nurses, and responders, it offers more than just data. It delivers clarity, confidence, and control at the point of care.
About ArcheOptix
ArcheOptix is a Canadian medical device company dedicated to transforming the way Traumatic Brain Injuries are assessed, delivering CT-level accuracy for rural communities, emergency response teams, sports medicine, and more. Our focus on innovation and clinical excellence drives everything we do.
