Medical Simulations for Extreme Cold Weather Environments

OUSD (R&E) CRITICAL TECHNOLOGY AREA(S): Combat Casualty Care OBJECTIVE: Develop and test proof-of-concept systems for training military medics to identify and treat various injuries in extreme cold weather environments. DESCRIPTION: During Operations Enduring Freedom and Iraqi Freedom, Army Combat medics centered a great deal of their training on injuries due to improvised explosive devices and gunshot wounds (Dougherty, Mohrle, Galarneau, Woodruff, Dye, and Quinn, 2009). The focus of this topic is training military medics for extreme cold weather environments. Two parallel areas of concern are hardening simulations to withstand extreme cold and providing training for non-battlefield injuries such as hypothermia and frostbite (Army Public Health Center, 2022). Highlighting the need across the services for a more collaborative approach to extreme cold warfighting capabilities, the DoD established the Ted Stevens Center for Arctic Security Studies on 9 June 2021 (DoD Fact Sheet, 2021.) Medics need to be able to identify what an injury is as well as know how to treat it. The former requires cognitive understanding and diagnostic ability, while the latter requires hands-on practice. Current patient simulators and part task trainers often fail in extreme cold due to shortened battery life, simulated skin becoming fragile, fluids (e.g., simulated blood) freezing, and electronics failing (J. Pederson, personal communications, September 12, 2022). Diagnosis and treatment cannot be limited to point of injury , but should include prolonged care, should the medic be required to treat the patient for extended periods of time. PHASE I: Phase I will result in proof-of-concept breadboard training systems for two or more extreme cold weather injuries that will operate in an extreme cold environment. Phase I of this effort will begin with a detailed analyses of various types of extreme cold weather injuries, difficulties treating injuries in extreme cold, and weather-related materiel issues (e.g., fluids, electronics, simulated tissue). Each analysis should include how best to train medics to initially diagnose and treat the injury, as well as what to expect from the injury over the course of 24 72 hours. Each analysis should also explore how best to train both diagnosis and treatment (e.g., part-task trainer, moulage on human standard patients, AR/VR/MR, or combinations). The resulting training proof-of-concept system should demonstrate solutions to the problems found during the initial analyses conducted at the start of this Phase I. PHASE II: Successful Phase II offeror(s) will develop proof-of-concept systems as described in Phase I into well-defined, tested, and documented systems that can train military medical caregivers to diagnose and treat selected extreme environment injuries, both at point of injury and in a prolonged care situation. Note that prolonged care does not necessarily imply field conditions; a patient can spend prolonged time in a Battalion Aid Station or Forward Surgical Hospital. Resulting systems must be designed with affordability, training effectiveness and usability, in terms of reduced instructor workload, in mind. Phase II will also explore linkages to the Synthetic Training Environment (Synthetic Training Environment, 2021). As pertinent to the Phase II prototype, offerors should also examine and rate leading human physiology engines on their ability to simulate physiological reactions to extreme cold. Offerors will provide a technical approach for integrating physiology engines into the prototype system during Phase III. During Phase II, the utility and maturity of the system should be demonstrated to military medical instructors. A training effectiveness evaluation using a relevant population should also be performed at a relevant military medical training center/schoolhouse. Ideally, the Phase II system should be demonstrated at a cold-weather exercise, such as Arctic Edge or Cold Response. PHASE III DUAL USE APPLICATIONS: During Phase III, the offeror will harden the system, ensuring it adheres to the latest Department of Defense cyber security requirements. In addition, user improvement suggestions gathered during Phase II shall be incorporated, as deemed appropriate by the Phase III funding customer. The resulting system will be well documented. Working with the Defense Medical Modeling and Simulations Office, the Ted Stevens Center for Arctic Security Studies, and service organizations involved in cold weather and extreme environments (e.g., 11th Airborne Division, 10th Mountain Division, Marine Corps Mountain Training Center, Fort McCoy's Cold Weather Operations Course), the topic proponent will seek potential funding partners. In parallel to working with transition partners, Phase III should include pursuing commercialization opportunities. Emergency medical facilities in austere environments involving high altitude and/or extreme cold could benefit from the same technologies. Civilian organizations training/certifying Wilderness Emergency Medical Technicians are potential customers. REFERENCES: 18. Army Public Health Center (2022). Cold weather casualties and injuries. Retrieved November 18, 2022 from https://phc.amedd.army.mil/topics/discond/cip/Pages/Cold-Weather-Casualties-and-Injuries.aspx 19. DoD Fact Sheet (2021). Ted Stevens Center for Arctic Security Studies: DoD's Newest Regional Center. Retrieved January 25, 2023 from https://media.defense.gov/2021/Nov/17/2002894807/-1/-1/0/DOD-TSC-FACT-SHEET-(FINAL).PDF 20. Dougherty, A. L., Mohrle, C. R., Galarneau, M. R., Woodruff, S. I., Dye, J. L., & Quinn, K. H. (2009). Battlefield extremity injuries in operation Iraqi freedom. Injury, 40(7), 772-777. 21. Synthetic Training Environment (2021). Retrieved November 10, 2022 from https://ste-cft.org/. KEYWORDS: Medical modeling and simulation, extreme weather medical training, cold weather medical training