The Burn Resuscitation Decision Support System developed at the U.S. Army Institute of Surgical Research was one of the ten Army Greatest Invention Award winners deemed by the U.S. Army Research, Development and Engineering Command for 2009.
The award will be presented to the USAISR at the 27th Army Science Conference in Orlando, Fla. Nov. 29 by Dr. Marilyn M. Freeman, Deputy Assistant Secretary of the Army (Research and Technology).
Optimal fluid resuscitation of acute burn casualties is one of the cornerstones of initial care for burn injuries. Clinical studies have shown that administration of either too much fluid or too little fluid in burn patients may be associated with less than optimal outcome. The BRDSS was designed specifically to assist providers who do not care for burn patients routinely. It utilizes an algorithm to generate recommendations for IV fluid rates to improve fluid balance during the initial 48 hours after the burn and avoid complications associated with inadequate or excessive resuscitation strategies.
The BRDSS resulted from the collaborative efforts of clinical research teams at the USAISR and the University of Texas Medical Branch Galveston, Texas. "Being named one of the Army's ten greatest inventions for 2009 is a great honor," said Dr. Jose Salinas, task area manager for Combat Critical Care Engineering at the USAISR, "it recognizes the hard work and dedication of both the clinical and research staff at the USAISR and UTMB to use cutting edge technology to provide the best possible care for burn patients."
Preliminary analysis of the BRDSS performance over the last two years in the burn centers at the USAISR and UTMB suggests that it has improved burn resuscitation management by reducing the volume of fluids given to patients with large burns while maintaining clinical goals and improving patient outcomes.
"Decision support systems such as this one have the potential to change critical care medicine, not just for burns, but for many other types of injuries and diseases by providing real time bedside augmentation of medical expertise" said Dr. George Kramer, Director of the Resuscitation Laboratory, Dept. of Anesthesiology, UTMB.
Based on its successful use in the USAISR, the U.S. Army Decision Gate Office has put the system into an accelerated acquisition track designed to develop a mobile version of the system that can be used by DoD providers deployed in support of overseas operations. This accelerated acquisition approach will allow the DoD to field mobile burn resuscitation units that provide decision support for burn resuscitation from the combat support hospitals in the field and throughout the evacuation chain across the different echelons of care.
"Ideally, this system will be used on large burn patients as soon as they arrive in a field hospital and will remain with the patient as he or she is globally evacuated from the initial treatment facility to the USAISR Burn Center." said Dr. Kevin Chung, Medical Director of the burn intensive care unit at the USAISR.
"Decision support systems and automation technology are critical to improving medicine. We hope this is just one of many future products that will help to improve the care of our critically injured Soldiers, Sailors, Airmen, and Marines" said Salinas.