Exonicus Inc. and Kitware have collaborated to develop a trauma simulator using the Pulse Physiology Engine.

Exonicus Inc. has been creating a virtual reality emergency medicine training simulator for military medical personnel using the Unity game engine. This work is led by Dr. Kyle Couperus at Madigan Army Medical Center and funded by the Telemedicine and Advanced Technology Research Center (TATRC).

Exonicus needed to include dynamic physiological feedback on the patient’s condition in their training environment. This included the need to represent a wide range of injuries to begin the simulation and account for user actions throughout the training scenario. Pre-scripting the scenarios would prove too limiting and could lead to poor training outcomes. After investigating how to incorporate physiology into Exonicus’ simulation, Janis Kondrats, the co-founder of Exonicus and a project manager for emergency medicine trauma simulations, wrote an article reviewing physiology engines, including the Pulse Physiology Engine. Based on this information, the two companies began collaborating on this development.

Pulse is an open-source physiology engine with a public repository for community use, advancement and collaboration in human physiology simulation research. Pulse is comprised of adult computational physiology models that can be used for research and education and paired with simulation modalities for a complete user experience.

The Kitware Pulse team worked with Exonicus to integrate the Pulse Physiology Engine into their emergency medicine trauma simulator. The trauma simulator is built in Unity, requiring several architectural updates to ensure easy communication between Unity C# scripts and Pulse. Kitware expanded the Pulse Common Data Model to include significant functionality in C# and changed its Google protobufs implementation to use JSON as the ASCII data file format.

Kitware also updated the Pulse models to allow for localized hemorrhage and the administration of packed red blood cells. The company developed a vital sign monitor in Unity and populated the monitor with both waveforms and numeric data for dynamic patient physiology updates.

Kitware will continue to expand the trauma simulator with Exonicus in the future.