Human-Based Training Methods
Because widely validated and accepted nonanimal alternatives for chemical casualty management and combat trauma training courses exist, there is no justification for the use of live animals for these training purposes.
Combat Trauma Training
The U.S. military’s combat trauma training courses teach military physicians, medics, corpsmen, and nonmedical personnel to respond to the most common causes of preventable battlefield fatalities, including extremity hemorrhage, airway compromise, and collapsed lung. Procedures to address these injuries can most effectively be taught in a course using high-fidelity medical simulation, partial task trainers, and immersive learning environments.
The most important elements of combat trauma training for military personnel are realism, human-specific injuries and treatments, volume of trauma exposure, and team building. Simulators provide the opportunity for trainees to learn to respond to these injuries using a realistic model of human anatomy and physiology.
HemaSTaT Training System
The HemaSTaT training system from Simulution, Inc., is designed to train and evaluate the skills used for the control of blood loss with nonextremity and noncompressible hemorrhage. The simulator allows for the teaching of hemorrhage control, use of hemostatic agents application that actually clot with the artificial blood used, wound packing, and verification of treatment success. The use of the HemaSTaT simulator provides effective human-based training to combat medics that will allow them to safely treat wounds in the battlefield.
Cut Suit Simulator
The Human Worn Partial Task Surgical Simulator (known as the "Cut Suit") from Strategic Operations is a training device worn by a human actor. It includes breakable bones, interchangeable organs, and variable blood flow. Wounds are created by the user, and the skin and other organs are repairable, allowing for multiple uses. The Cut Suit combines the sensation of working on live tissue with the realism of performing procedures on a conscious “casualty.”
Operative Experience, Inc.
Using medical simulators with unprecedented anatomical and surgical fidelity, the devices from Operative Experience can reduce training costs while increasing effectiveness. This training is more effective, more efficient, and more realistic than live animal-based training for many surgical procedures.
Human-patient simulators such as SimMan can be used to teach the core skills of treating injuries involving breathing, the heart, and circulation. SimMan is a full-body simulator that is already used in medical schools and hospitals around the country to teach civilian medical practitioners many of the same procedures being taught in the U.S. military’s combat trauma training courses.
Combat Trauma Patient Simulator
Partial Task Trainers
Many U.S. military training programs use task trainers, simulators which replicate specific parts of anatomy for training such as intubation or surgical airway. CHI System’s HapMed limb simulator, for example, is a manikin arm that provides skills training in which trainees can properly learn and practice tourniquet application, a crucial procedure given the number of extremity wounds suffered by service members in Iraq and Afghanistan.
Center for Sustainment of Trauma and Readiness Skills
The Air Force’s Center for Sustainment of Trauma and Readiness Skills (C-STARS) program exemplifies how effective trauma training can be achieved by combined use of simulators, human cadavers, and civilian trauma centers.
At centers in St. Louis, Cincinnati, and Baltimore, C-STARS courses teach chest tube insertion using simulators, fasciotomy using cadavers, and a number of other procedures under supervision on live human patients who enter trauma centers with severe injuries.
Immersive Battlefield Environments
Simulation is most effective when used in scenarios that replicate the sights, sounds, and smells of the battlefield. Immersive battlefield environments are already used by the U.S. military to acclimate deploying soldiers to the “fog of war.” In these scenarios, soldiers learn to complete their missions while navigating through smoke, dodging simulated gunfire, and coping with nearby explosions.
These training sessions must be expanded to include the use of medical simulators in combat trauma training courses.