Sandia LabNews

Biological agent released in virtual airport tests readiness to treat mass casualties

Virtual reality training tool pits rescue teams against computerized terrorist attack

In the emergencies of tomorrow — when rescue personnel may need to treat mass casualties following release of a nerve agent in a shopping mall, theme park, or subway, for instance — there will be no second chances. Rescuers who become victims of a terrorist attack can’t save lives.

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VIRTUAL CASUALTY Lydia Tapia of Proliferation Sciences Dept. 5913 demonstrates BioSimMER, a virtual reality application developed at Sandia that soon will allow rescue personnel to practice responding to a terrorist attack involving release of a biological warfare agent. Through her goggles, Lydia sees the scene that is displayed on the screen behind her. The virtual patient she is treating suffers from a severe head wound and exhibits realistic symptoms, such as heavy breathing and rapid eye movement. If Lydia doesn’t administer the proper medical procedures in time, the patient will die. (Photo by Randy Montoya)
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Soon emergency medical technicians (EMTs) and firefighters may be able to practice responding to such attacks using a virtual reality (VR) training tool under development at Sandia.

Computer scientists in Proliferation Sciences Dept. 5913 have combined seven years of virtual reality research into BioSimMER, a VR application that immerses first responders in a computer-simulated setting a small airport in which a biological warfare agent has been dispersed following a terrorist bombing. Simulated casualties with a variety of symptoms are found throughout the airport.

BioSimMER can help emergency personnel make better decisions if ever they are called upon to respond in a real chem-bio attack, says project leader Sharon Stansfield (5913).

"With virtual reality, you can practice over and over again, like in a video game," says Sharon. "You make mistakes, you learn. If someone dies, you can hit the reset button."

The computer simulation engages the rescuer’s eyes, ears, and decision-making abilities through goggles that display the scene’s images. The rescuer wears sensors on the arms, legs, and waist, allowing the player’s motions to be fed back into the simulation.

Saving ‘cyber casualties’

The researchers worked closely with Dr. Annette Sobel of Proliferation Projects Dept. 5908 to create "cyber casualties" with realistic symptoms and real-time changes in their conditions based on the player’s actions. One virtual casualty has a visible chest wound. Another has symptoms that indicate head trauma.

Another suffers from inhalation of Staphylococcal enterotoxin B (SEB), the airborne bio agent used in the simulation. And a fourth appears to exhibit the symptoms of SEB exposure, but closer examination shows him to be suffering from psychological shock.

During a simulation, the player must do triage, diagnose, and attend to the medical needs of each casualty. Visual indicators (like a victim’s movements, labored breathing, or skin color) and vital signs (such as blood pressure, temperature, and heart rate) give clues to each victim’s condition. If the rescuer is wrong — or not fast enough — the casualty could die.

"Civilian responders have a tendency to want to save everybody," says Sharon. "With mass casualties, that may not always be possible."

After making a diagnosis, a player can administer medical treatment by reaching for and using tools in a virtual medical kit. Players may need to attend to initial decontamination procedures, place masks over a patient’s nose and mouth, or place sensors or other monitoring equipment near the patient. Most important, they need to learn to protect themselves.

"A player who dies a quick cyber death will not likely forget the importance of personal protective equipment in the future," says Sharon.

A suspension of disbelief

Although textbook-style preparation and live training exercises are valuable pursuits as the nation’s emergency personnel prepare for future emergencies, says Sharon, BioSimMER offers some additional advantages.

"We tend to understand what we see with our eyes and do with our hands," she says. "The strength of VR is being able to train on things you can’t do otherwise, particularly in highly contaminated or highly stressful situations."

And running a computer simulation over and over again is relatively inexpensive, she adds, whereas live exercises typically can be run far less often.

"We don’t think BioSimMER should replace live exercises," she says, "but it can provide an inexpensive way for emergency personnel to practice."

Making all the pieces of a VR simulation "play together" is no small task, adds Sharon.

"In video games, the world is imaginary," she says. "But a VR world is a representation of a real place with representations of real people moving in real time. Everything in that world must move and respond as if it was real and bound by the laws of physics.

"You’ve got to make the player believe, at least temporarily, that they are in the situation you are presenting to them," she says. "You need to create a suspension of disbelief."

The BioSimMER team includes an artist — Monica Prasad (5913) — whose expertise in creating three-dimensional representations of people and places adds to the realism of the application. "Sometimes people point out that VR applications look a little cartoonish," says Sharon. "They wonder why the graphics aren’t as good as the latest 3-D video game."

That’s because in order to get the necessary physical realism in real time, she says, you have to make some tradeoffs.

"Monica helps us build environments that look good based on her knowledge of how the world should look," she says.

Other members of the VR technical development team include Dan Shawver, James Singer, and Lydia Tapia (all 5913). Richard Griffith, John Brockmann (both of Plasma and Aerosol Sciences Dept. 9114), and Ken Murata (Modeling and Analysis Dept. 6421) calculated and modeled how the biological agent would spread through the airport following an explosion that dispersed the agent.

The airport model used in BioSimMER is a fictitious one-story, three-gate airport, but Sharon admits it is based loosely on the small airport in her hometown, Ithaca, N.Y.

Test driving BioSimMER

This week, first responders are getting their first chance to test drive BioSimMER at the National Emergency Response Training Center at Texas A&M University. More than 30 EMTs will each take the program for a short spin, giving the Sandia team valuable feedback on potential improvements.

Development of BioSimMER was funded by the Defense Advanced Research Projects Agency (DARPA). BioSimMER also builds on previous Sandia virtual reality work, including the Medisim application for training battlefield medics, and VRaptor for small-teams law enforcement tactical training.

"Those people out there — the police, the firefighters, the EMTs — they do important jobs," says Sharon. "They are telling us they want this. If we can do something to help them, then we are using technology to make a real contribution to society."

Immediate plans for BioSimMER include making user interaction with the virtual world easier and more realistic — an improvement made possible by new funding from DOE’s Office of Science and Technology Pilot Projects in Biomedical Engineering Program, says Sharon.