Creation and application of war trauma treatment simulation software for first aid on the battlefield based on undeformed high-resolution sectional anatomical image (Chinese Visible Human dataset)

Abstract

Background: Effective first aid on the battlefield is vital to minimize deaths caused by war trauma and improve combat effectiveness. However, it is difficult for junior medical students, which have relatively poor human anatomy knowledge and first aid experience. Therefore, we aim to create a treatment simulation software for war trauma, and to explore its application for first aid training. METHODS : This study is a quantitative post-positivist study using a survey for data collection. First, high-resolution, thin-sectional anatomical images (Chinese Visible Human (CVH) dataset) were used to reconstruct three-dimensional (3D) wound models. Then, the simulation system and the corresponding interactive 3D-PDF, including 3D models, graphic explanation, and teaching videos, were built, and used for first aid training in army medical college. Finally, the interface, war trauma modules, and training effects were evaluated using a five-point Likert scale questionnaire. All measurements are represented as mean and standard deviations. Moreover, free text comments from questionnaires were collected and aggregated.

Results: The simulation software and interactive 3D-PDF were established. This included pressure hemostasis of the vertex, face, head-shoulder, shoulder-arm, upper forearm, lower limb, foot, and punctures of the cricothyroid membrane, pneumothorax, and marrow cavity. Seventy-eight medical students participated in the training and completed the questionnaire, including 66 junior college students and 12 graduate students. The results indicated that they were highly satisfied with the software (score: 4.64 ± 0.56). The systems were user-friendly (score: 4.40 ± 0.61) and easy to operate (score: 4.49 ± 0.68). The 3D models, knowledge of hemostasis, and puncture were accurate (scores: 4.41 ± 0.67, and 4.53 ± 0.69) and easily adopted (scores: 4.54 ± 0.635, and 4.40 ± 0.648). They provided information about hemostasis and puncture (all scores > 4.40), except for cricothyroid membrane puncture (scores: 4.39 ± 0.61), improved the learning enthusiasm of medical students (score: 4.55 ± 0.549), and increased learning interest (score: 4.54 ± 0.57).

Conclusion: Our software can effectively help medical students master first aid skills including hemostasis, cricothyroid membrane and bone marrow puncture, and its anatomy. This may also be used for soldiers and national first aid training.

Keywords: Chinese Visible Human; First aid; Sectional anatomy; Self and mutual rescue; War trauma.

Fig.1

Creation workflow of treatment simulation software on the battlefield. CVH, Chinese Visible Human. 3D, three-dimensional. UI, user interface

Fig.2

The interfaces of the treatment simulation software a, User login interface; b, Injury treatment module selection interface. c. Basic knowledge of injuries interface; d, Interactive learning interface of the 3D digital anatomy and sectional anatomy; e, Interactive learning interface of the 3D digital anatomy; f, Lecture video interface; g, Interactive learning interface of the sectional anatomy; h, Interactive learning interface of CVH sectional anatomical images and the 3D model; d-1, Clickable area of the 3D model display, and lecture videos; d-2, Sectional anatomical image, CVH and 3D model learning button area

Fig.3

Learning module on bone marrow puncture a, Injury demonstration; b, Error message when selecting the wrong puncture position; c, Demonstration of the correct puncture point of injury after transparency of the skin; d, Selecting of the correct puncture position and confirmation to proceed to the next step; e, Animated demonstration of puncture; f, Teaching video of the correct puncture techniques

Fig.4

Pressure hemostasis interface of the lower limb in 3D-PDF document a, Functional area of the anatomic model; b, Demonstration area of text of first-aid technology; c, The 3D digital anatomy window; d, Interactive learning interface of the 3D digital anatomy

Fig. 5

The mean score and standard deviation of groups of 16 questions in the questionnaire; *, p < 0.05 for comparison between groups; †, p < 0.05 for comparison with cricothyroid membrane puncture in question 5;△,p < 0.05 for comparison with pneumothorax puncture for airway obstruction in question 12