HapMed's Extremities-Multiple Application Trainer (E-MAT) Arm provides Army personnel a simulated arm with sensors and an on-board computer that determines whether they have applied a tourniquet correctly. It is great for learning this extremely important manual skill. Extremity hemorrhage is one of the three major preventable forms of death highlighted in the Army's Tactical Combat Casualty Care (TC3) program. TC3 is an initiative that teaches combat medics how to do point of injury care in a tactical environment. TC3sim is a game-based simulation that allows the player to take on the role of a combat medic and make decisions about triage, treatment, and tactical safety. But, it does not support any hands-on training.

This paper will discuss the work to combine these two simulation systems. TC3sim provides training for tactical situational awareness and high-level decision-making. HapMed's E-MAT Arm provides training for hands-on medical skills. An interface between TC3sim and HapMed's E-MAT Arm is authored to allow data to be shared. HapMed's E-MAT Arm physiological data about bleeding rate and tourniquet effectiveness are sent to TC3sim to incorporate into its larger scenario. The virtual wounded soldier's wounded state, simulated by TC3sim, now incorporates data from HapMed's E-MAT Arm. Effectively, HapMed's E-MAT Arm now simulates the soldier's amputated arm. The trainees have the opportunity to practice their medical decision-making knowledge and their tourniquet application skills. They get the best of both worlds: a low resource impact substitute for a live exercise and an effective training tool for manual medical skills.