Augmented Reality Triage Aid for Medics: Visualization of Trauma and Decision Support for Combat Casualty Care

Rationale: Combat Casualty Care (CCC) for the wounded Warfighters in Multi-domain Operation (MDO) battlefield or austere environment makes medical knowledge, skills, and efficiency of the military medical professional paramount, especially given the limited medical resources. These concerns for delayed evacuation to surgical and definitive care, also known as Prolonged Field Care (PFC), further emphasize the necessity to ensure maximal resources and state-of-the-art medicine are available in the battlefield setting. For wounds that extend deep into internal anatomy, high-fidelity visualization of internal anatomy aligned with the injury Warfighter, when displayed on an portable augmented reality (AR) headset, can enable more efficient and effective evaluation with safe and optimal treatment when presented to medical providers positioned close to the point of injury (POI), much in the way that CTs have enabled better musculoskeletal care at forward medical units. Objective: Our project leverages the medic's aid created in DHA SBIR 191-001, 'Augmented Reality Surgical Visualization Tool for Combat Casualty Care,' managed by Dr. Gary Zientara of USARIEM. The AR tool provides visualization of healthy human internal anatomy superimposed on the injured Warfighter using the Army's Integrated Visual Augmentation System (IVAS) goggles. The main objective of this proposed project is to add realistic trauma visualization and valuable decision support to the SBIR AR tool in order to create an enhanced medic and Buddy Care triage and decision support aid for use in the battlefield or austere environment, improving survivability during PFC and in cases of mass casualties. Specifically, we aim to (1) create computer vision software that identifies the location, extent, and wound type, compared to the TC3 manual; (2) create software to remodel the warfighter FE avatar to represent the wound(s) or trauma; (3) augment SBIR AR system software to project a graphic visualization of the Warfighter wounded anatomy, accompanied by assessment and treatment support information; (4) implement on IVAS, or Microsoft Hololens 2 if IVAS unavailable, test, and evaluate in conjunction with AMEDD Combat Medics School 68W. Potential DoD and Civilian Applications: This proposed work addresses the addresses the FY18-FY22 DOD USAMRMC BAA Focus Area(s) of the Combat Casualty Care Research Program (CCCRP), aiming to 'reduce the mortality and morbidity associated with major combat-related trauma across the spectrum of combat casualty care, including point-of-injury and pre- or out-of-hospital care, the spectrum of en route care, and facilities-based treatment.' The proposed work will lead to the rapid development and translation of this AR triage aid for medics with visualization of trauma and decision Support for CCC. The impact of our AR system would contribute to the increase in the survivability of potentially survivable cases by providing the aid to the medic's SOP repertoire and, as important, timely assessment and treatment advice if only Buddy-care is available. It will improve medical readiness, mitigating fatalities, and optimally treating life-threatening injuries. The product can also be used in a medical training classroom or included in medical training curriculum in both military and civilian medical schools or laboratories. It can also be used for military games or training simulations. Civilian commercialization potential could be huge as well. Many medical schools can use the product for medical training of students. Small primary and secondary hospitals that do not wish to invest in a large surgical visualization platform are a market for a portable AR surgical visualization system. Doctors can use the product to communicate or consult with patients to better explain anatomical and medical problems. The AR tool hardware system and display software can also be valuable in the consumer electronics market once adapted and deploy