ARA is transforming how the U.S. Army trains its medics to treat serious burn injuries. The research and development company’s training application is called BurnCARE, which stands for Burn Computer Application for Research and Education. BurnCARE features new, high-fidelity virtual burn patient models currently not available to the Army for training. The application is designed to run on mobile devices, which means that medics, even ones who don’t usually treat burn patients, can train anywhere, including on the road during deployment.
This effort is led by ARA’s Virtual Heroes Division, globally recognized serious games experts who have been creating 3D training, simulation, and virtual-world experiences for over 17 years. Their three-year contract with the Army Research Lab’s Simulation and Training Technology Center focuses on easy-to-access burn care training, specifically high visual fidelity, replayability, and portability. Supporting Virtual Heroes are acclaimed subject matter experts (SMEs) at the U.S. Army Institute of Surgical Research (USAISR), the sole combat Department of Defense burn care facility, and ARA’s BioGears group, which specializes in creating validated physiological models. The team’s goal is to create accurate, realistic training, which is randomizable and replayable. Medics who have never had to treat burn patients can practice crucial evaluation and treatment procedures again and again until they get them right.
Says BurnCARE’s Project Manager Marcia Clover, “Burn care is such an important and specialized type of patient care. When not performed correctly, it can impact the patient’s mobility and overall quality of life forever. Working with the USAISR SMEs, who literally ‘write the book’ on burn care treatment, we learned there may be times when medics are deployed with little or no hands-on burn care experience. We’re honored for the opportunity to be part of this important training effort and give medics crucial knowledge on how to assess and treat a burn patient.”
The BurnCARE prototype trains two procedures: estimating Total Burn Service Area (TBSA) and performing an escharotomy. Measuring the initial burn surface area is important in estimating fluid resuscitation requirements, since patients with severe burns will have massive fluid losses due to the removal of the skin barrier. Medics tend to overestimate the TBSA, which could mean patients receive more fluids than necessary. An escharotomy treats the most severe (third-degree) burns, where both the epidermis, dermis, and sensory nerves have been destroyed. Medics must cut tough, leathery skin to relieve pressure and restore blood circulation. An escharotomy can save a patient’s extremity–a hand, a foot, an entire leg–when the burned skin is acting like a tourniquet.
USAISR SMEs ensure that the patient assessment and treatment steps performed in BurnCARE are accurate and simulate reality. USAISR also provided invaluable reference material enabling the development team to create very realistic post-debridement burn wound textures for all second and third degree burns used in the training scenarios.
The training scenarios are built on Epic Games’ Unreal Engine 4, a cutting-edge real-time 3D creation tool that scales to run photorealistic applications on mobile devices, with or without an Internet connection. Medics can train with realistic virtual burn patients no matter where they are, when training in a classroom environment isn’t possible. The terminal goal of the training scenarios is to make the patients stable and ready for transfer.
BurnCARE is currently available as part of the Google Play store test program. Approved testers can download the application for free onto Android tablets and experience both TBSA and escharotomy modules as early-access versions.
Wide release to the public on the Google Play Store is targeted for December 2021.
Future development will target iOS on Apple devices. Virtual Heroes developers are currently adding modules to train fluid resuscitation and pain management, and possible future modules will include patient handoff procedures to reduce caregiver miscommunication when a patient is transitioning from acute to long-term care. Future users could include not only deployed medics but also global healthcare workers in a hospital setting, including nurses, physician’s assistants, and doctors with varying levels of expertise in treating burn patients.