CrashSavers Simulator

Trauma is a global public health problem disproportionately affecting low-and-middle income countries (LMICs). With resource limitations and workforce shortages, medical staff without formal trauma training are often faced with managing patients with complex, life-threatening injuries. Many lives can be saved with simple, easy-to-perform maneuvers and decisive action but, in too many settings, the workforce encounters too few patients with such injury patterns to develop familiarity. 

Formal courses in trauma are difficult to access for LMIC physicians and often rely on expensive, in-person instruction. CrashSavers will be a realistic, simulation-based game that teaches advanced trauma decision-making and core procedures (e.g. FAST, tube thoracostomy, cricothyrotomy) in an engaging digital platform available to anyone with a computer and internet connection. CrashSavers will actualize guidelines, clinical information, and procedural instruction into digestible, virtual clinical scenarios and will use the latest techniques in gamification to provide an exciting format for self-assessment.

CrashSavers will place the user in the shoes of a medical novice entering a hospital for her first shift as emergency staff. The user’s first assignment is to watch a tutorial and read guideline summary documents. Once the shift begins, the user will be required to synthesize her existing clinical knowledge with what she has learned in the guidelines towards the evaluation and management of trauma patients. 

The platform will leverage the latest in mobile technology to teach core trauma procedures such as the (1) focused assessment with sonography in trauma (FAST) exam, (2) tube thoracostomy, (3) cricothyrotomy, (4) cystostomy, and (5) obtaining vascular access. For example, the FAST module feature will utilize the accelerometer on commonly available smartphones to virtually perform a FAST exam. Appropriate positioning of a calibrated smartphone will reveal images from the patient’s FAST exam that will be needed for clinical decision-making. 

We will base the training and self-assessment system in CrashSavers on validated data on task repetition and gamification of educational content. All appropriate management decisions and successful completion of procedures will be awarded points. Users will encounter patients and clinical scenarios of higher complexity as they progress from ‘novice’ to ‘Trauma Chief’.

1. Initial evaluation, assessment, and management of the trauma patient

2. Indications for adjuncts and further diagnostics in trauma evaluation

3. Indications and performance of core trauma procedures

   1. Focused Assessment with Sonography in Trauma (FAST)

   2. Needle decompression and tube thoracostomy

   3. Cricothyrotomy

   4. Cystostomy

   5. Vascular access (intravenous catheter, central line, intraosseous access)

CrashSavers will be designed for a meaningful experience for all levels of medical practitioners, starting at the novice to the seasoned clinician in need of a refresher. The platform will be accessible to any clinician in any part of the world, on-demand, with access to a computer with an internet connection. Optimal use of specific modules (e.g. FAST) will need a modern smartphone with an accelerometer but these modules can be bypassed if users do not have access to these tools. 

In many ways, the seasoned trauma practitioner has built confidence in his or her patient management through exposure to many hundreds or thousands of trauma patients. CrashSavers will improve user skills in managing complex trauma scenarios and basic procedure performance through repetition in a gamified digital environment with access to algorithms and procedural instruction. The game will have in-built evaluation tools to objectively identify user strengths and weaknesses, and tailor further instruction to those needs.

Team Lead:

Juan Carlos Salamea MD, Hospital Universitario del Río, University of Azuay, Cuenca, Ecuador

Clinician / Educators:

Dr. Pablo Ottolino, Trauma Surgeon & Surgical Educator, Hospital Sotero Del Rio, Universidad Catolica, Santiago, Chile

Dr. Sabrina Austurias, Trauma Surgeon & Surgical Educator, Universidad Francisco Marroquin, Guatemala

Dr. Juan Pablo Ramos, Trauma Surgeon & Surgical Educator, Hospital Sotero Del Rio, Universidad Catolica, Santiago, Chile

Dr. Analia Zinco, Trauma Surgeon & Surgical Educator, Hospital Sotero Del Rio, Universidad Catolica, Santiago, Chile

Dr. Nakul Raykar, Trauma Surgeon & Surgical Educator, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

Technical Expert:

Dr. Gabriel Escalona, Trauma Surgeon & Surgical Education Innovator, Universidad Catolica, Santiago, Chile

Dr. Favio Reyna, Radiologist and Professor of Auxiliary Technologies, Universidad Francisco Marroquin, Guatemala

Clinician partners from LMICs