The Department of Defense, specifically the Army, is seeking proposals for the Small Business Innovation Research (SBIR) program focused on the development of a "Predictive Simulation of Injury Progression." This initiative aims to create dynamic digital representations of combat-related injuries and their internal healing processes, enhancing the training of medics in Prolonged Casualty Care scenarios. The technology is crucial for preparing military personnel for complex medical situations during large-scale combat operations, where traditional casualty evacuation may be limited. Phase I proposals are invited with a funding amount of up to $250,000 for a six-month performance period, with the application deadline set for May 21, 2025. Interested parties can find more information and submit proposals through the official SBIR website at https://www.dodsbirsttr.mil/topics-app/.

## Description

Moulage, or simulated injuries, lack the ability to change over time based on correct or incorrect treatments. In addition, and perhaps more importantly, they lack the ability to depict what is occurring under the visible injury, i.e., what the body is doing to heal the injury or why the treatment presented was incorrect based on internal physiological processes. By incorporating digital technologies (thin-film displays are only one example of a potential solution), a trainee can see a realistic digital representation of an initial injury, select an initial treatment, then see how the injury would be expected to progress (or regress) over the course of time &ndash; all in a matter of minutes as opposed to hours. This capability will depict the underlying anatomical structures and physiological processes that triggered visible changes. This internal view can provide a much deeper cognitive understanding of long-term progression of injuries. This deeper understanding can help better prepare medics for the challenge of providing Prolonged Casualty Care, as the military moves from Counter-Insurgency operations (COIN) to Multi-Domain Operations (MDO), potentially facing peer or near-peer opponents in Large Scale Combat Operations (LSCO). During such operations, the military is expected to face anti-access/area denial tactics from perceived opponents, limited casualty evacuation opportunities forcing units to treat casualties for extended periods of time. The ideal solution will not encumber the trainee with any head-worn device beyond prescribed safety devices worn in operational settings. 

## Objective

This topic seeks to explore technologies that can enable dynamic representations of combat-related injuries, as well as the internal processes that take place over time as the injury changes due to treatment. The goal is to provide medics with a deeper understanding of how various treatment decisions impact long-term injury recovery.

## Phase I

This topic is accepting Phase I proposals for a cost up to $250,000 for a 6-month period of performance. A successful Phase I effort will result in a comprehensive market analysis of existing and emerging digital display technologies, and how best to leverage it to resolve this problem. Solutions for incorporating displays for both manikins and human actors (standard patients) should be addressed. Any proposed solution will not include any trainee-worn device any more encumbering than glasses issued for eye safety for combat operations. An analysis of common injuries expected in Tactical Combat Casualty Care (TCCC) scenarios as well as injuries expected to pose problems in Prolonged Casualty Care (PCC) should be performed, with descriptions of how the injuries progress, or regress, depending on the treatment provided. In addition, a plan for how the underlying anatomy, tissues, and physiological processes involved in the injuries&rsquo; change over time, to be depicted in Phase II, should be prepared. 

## Phase II

Phase II will see the successful development of digital displays that depict both TCCC-specific and PCC-specific injury progressions, based on the initial injury and treatment, and on-going treatments. The displays shall be both human-worn and manikin-worn. A variety of injuries shall cover a spectrum of relatively easy treatments (e.g., tourniquet application, wound packing) to more complex (e.g., lower limb fasciotomy). All injuries shall depict both superficial representations of the injury as well as internal depiction of any anatomical structure, tissues, and physiological processes involved in how the injury changes over time. Trainees shall have the ability to select treatments (both initial and on-going) via a menu, either showing on the display or on an external device. An after-action review shall present the trainee with information about the initial injury and the trainee&rsquo;s course of treatment, and how the injury changed over time, depicting the physical representation of the injury and the internal views side-by-side.

## Phase III: Dual Use Applications

Direct sales could support Army medical training schools and centers, as well as the Uniformed Services University of Health Sciences (USU). Commercially, the technology produced would be of value to civilian hospitals, medical schools, and emergency medical services training centers.

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