Video Games Hone Triage Skills

The video game market has stormed the U.S. like a commercial juggernaut. PricewaterhouseCoopers, a global professional services and consulting firm, estimates that consumer spending for console and handheld games will reach $11.7 billion in 2012, a noticeable increase over the $8.6 billion in 2007 the firm recorded.

This upturn means that games about shooting, beating and blowing up people are on the rise. But there's a lesser-known game genre whose chief goal is training and educating, rather than entertaining vicariously through digital violence.

TruSim, a division of Blitz Games Studios in the UK, develops serious games for the growing market of training simulations for the health-care, military and corporate arenas. The developer's latest innovation is Interactive Triage Trainer, a prototype designed to train first responders on how to prioritize casualties after a catastrophe.

A gameplay video reveals that players are transported to a city street that's been ravaged by a bomb blast. You can tell it's just a game, but the graphics are realistic enough to inform the user that this playing experience is an impressively three-dimensional rendered affair that's on par with much of what's available for the current generation of home video game consoles.

As the scenario begins, the sidewalk is a mess of broken glass, overturned chairs and wood and metal bars, and three civilians have suffered varied injuries. In the game, players move the cursor to look around the scene, but in the video the player immediately starts sorting the people who need urgent attention from those who don't. This is done by instructing everyone who is well enough to walk to go to the ambulance crews -- an action called a mobility sieve. Then the player can focus on the remaining people who are too injured to move themselves.

Players move the cursor from casualty to casualty and pick which one to examine. Randomly generated victims are dispersed with various injuries, such as exposed organs and bones, profuse nosebleeds, someone lying face up with no external injuries or deceased.

Once at a casualty, players enter "examination mode" and are offered five triage options: The player can talk to the casualty to see if she can talk back; check her airway, breathing rate or pulse rate; and perform a capillary refill check for blood flow. (In a real-world capillary refill check, a first responder holds the victim's hand up and presses a fingernail for about five seconds; the time it takes for the color to return to the flesh beneath the nail is the capillary refill time.)

When players finish the triage actions, they tag the casualty based on who needs care the most. They can label a casualty priority 1, immediate; priority 2, urgent; priority 3, delayed; or priority 4, deceased. The game scores players' decisions after they've tagged all casualties, informing them if their actions were correct for each casualty addressed.

Partners in Lifesaving

Virtual training could give first responder students a more immediate feel for actual medical emergencies than traditional training exercises where medical students pretend to be injured.

"They can't make themselves pale. They can't give themselves shallow breathing," said Jolyon Webb, an art manager for TruSim. "They can't kind of force adrenaline to their system to make them sweat. They just have to tell you that 'I'm sweaty. I'm kind of feeling very pale and faint.' With a digital character, you can actually make all of those things explicit and show them to people."

According to Webb, the idea for Triage Trainer began in 2006 as a research project commissioned in part by the UK's Ministry of Defence to train field-hospital personnel in conflict zones. TruSim worked on the game with technology partners, including Vega Group, a UK-based technology training and consulting company that's been involved with virtual academies and aviation training simulations.