When service members’ lives are endangered during tactical operations, natural disasters, accidents, and medical emergencies, MEDEVAC personnel serve as a lifeline by providing care and transportation to treatment facilities. Increasingly, military forces operate over extended distances, requiring longer travel to medical centers for surgery or other procedures, which can put critical patients at risk. During transit by ground or air, MEDEVAC responders must maintain patients’ stability. As the well-established theory of the golden hour has shown, stabilizing major trauma patients within 60 minutes of severe injury vastly increases survival rates. Along with caring for patients, first responders must also be able to maintain the equipment patients rely on for survival—including oxygen concentrators, defibrillators, and fluid pumps—during conveyance to treatment facilities.
To advance both medical care and medical equipment training for ground MEDEVAC personnel, CTMA has facilitated a collaboration between industry partner Defense Engineering Services (DES) and the Army’s Program Executive Office Ground Combat Systems (PEO GCS) and Medical Center of Excellence. The team is collaborating on a two-phase project, Improving Medical Equipment Maintenance and Sustainment through Simulators and Trainers. To prepare future DOD medics to use and maintain lifesaving medical equipment, the collaborators are producing two integrated training simulators.
During the first phase, which began in July 2020 and is scheduled to wrap up at the end of January 2022, the team has been manufacturing a training simulator that replicates the hardware and systems of the Army’s newest ground tracked vehicle ambulance, the Armored Multi-Purpose Vehicle (AMPV) MEDEVAC (ME). The AMPV ME is used to treat and transport wounded personnel, while protecting them in a variety of environments and terrains. This vehicle contains three seats, for a driver, commander, and medic, and can carry four litter casualties, six ambulatory casualties, or a combination of both.
The training simulator—which has been designed with the same size, dimensions, and workspace of the actual AMPV ME—is a stationary unit but can be moved with heavy lifting equipment. Inside, the simulator will replicate the AMPV ME’s seating, patient compartment area, and all other elements, including medical equipment. With a fully operational litter lift system, trainees will be able to practice loading/unloading and treating casualties. Instructors will have the capability to monitor and manipulate both the trainer environment as well as the high-fidelity human patient simulator (HFHPS) from an affixed control station. This control station will be able to record audio, video, and HFHPS telemetry during scenario training and features playback for after action review activities.
The AMPV ME simulator will prepare trainees for the sustainment challenges of medical equipment that occur in harsh conditions. It can mimic complications caused by shock and vibrations due to rough terrain, extreme temperatures, limited access to reliable electricity, and environmental contaminants such as dust and sand. A recent study that tested 34 vital medical devices under extreme conditions of temperature, humidity, altitude, and vibration found that 32% of the devices failed at least one environmental test and required operator troubleshooting to regain operational status. The frequent failure of these devices makes it essential for trainees to learn how to make in-situ repairs in often turbulent environments. This simulator facilitates realistic scenarios for understanding how to operate, evaluate, and repair all critical medical equipment needed to support life for the length of the simulated journey.
Phase II, which began in June 2021 and is scheduled to be completed in December 2022, has applied the lessons learned in Phase I to building a second training simulator. This unit will train personnel to work out of a mobile surgical unit vehicle that can move to sites of pandemics, earthquakes, tsunamis, and other natural disasters. A mobile surgical unit is essentially an operating room that can travel anywhere it is needed for medical personnel to conduct surgery and other complex medical procedures when timely medical evacuations are not possible. This simulator is being designed to train mobile field surgical and treatment personnel to provide surgical medical care and surgical medical equipment maintenance.
The simulator will allow trainees to practice loading/unloading and treating patients, as well as operating and maintaining the medical equipment. Like the simulated AMPV ME, the simulated mobile surgical unit will contain replicas of complex and sensitive medical equipment that can incur damage and other maintenance issues where key medical device spare parts or replacement components are unavailable. With limited space inside a surgical unit, and the need for quick set-up to treat critical patients, the simulator can mimic the conditions in which trainees must learn to function. The project team is designing modular components that replicate various medical treatments and surgical procedures. These components will ensure that trainees learn to troubleshoot and resolve medical device and equipment maintenance issues that happen during cross-country mobility and extreme weather.
While hands-on learning with real patients and medical equipment cannot be completely replaced, simulation training establishes a safe environment that allows trainees to learn from procedural mistakes without fear of harming patients. Simulation training equips trainees with the confidence to manage similar real-life scenarios, including equipment failure and repair.
The simulators will benefit the DOD by producing more highly trained MEDEVAC personnel, bettering patient care, increasing survival rates for injured service members, enhancing operational readiness for medical equipment and devices, reducing healthcare costs, and lowering total equipment lifecycle costs. This initiative’s realistic training environment can be applied to a wide range of other MEDEVAC platforms and training programs across the DOD.