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3D Bum Resuscitation: Free Medical Smartphone Application Chonburi Hospital, Ministry of Public Health , Thailand

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3D Bum Resuscitation: Free Medical Smartphone Application Chonburi Hospital, Ministry of Public Health , Thailand 3D Bum Resuscitation: Free Medical Smartphone Application Chonburi Hospital, Ministry of Public Health , Thailand The accurate total body surface area burned (TBSAB) estimation is a crucial aspect of an early burn-care management. The program provides guideline for resuscitation, which is essential for the calculation of fluid requirements. Conventional methods of burn estimation often lead to large discrepancies in burn percentage estimation because of its two dimension view, no body type included and gender/shape differences. “3D Burn Resuscitation” application for android and IOS applicable to all smartphones. This is the only application that employs the use of 3D body scanning technology on Asian-specific body to develop the models. The application is now available for free via Google Play and App Store. Users can enter patient parameters including height, weight and gender in to the application. Various 3D anatomical models differentiated by gender and BMI are suggested by the application. The 3D Burn application provides more accurate total body surface area burn measurements when compared to conventional methods as proven by volunteer subjects study and actual usages by various healthcare workers. With the advent of technology and the push towards electronic data, free download, no special equipment, no internet, easy technique, fast, more accuracy and reliability, the 3D burn application could be a key step in replacing the conventional total body surface area burn measurement. One of the most common %TBSA estimation is L&B tables. L&B Estimation method is based on a 2- dimensional diagram and it is not what the actual body is. So, we developed the 3-dimensional model for %TBSA estimation to correct these potential error since 2011. In 2011, we developed the Thai 3D Burn computer software. 3 Male and 3 female are brought into a 3- dimensional body scanner to derive the 6 standardized 3-dimensional diagrams to represent total body types. In 2016, The program was available for smartphone and tablet application. The program can be downloaded for Free for android and IOS operating system. We can estimated Burn surface area by conventional method Rule of palm, Rule of nines, Lund and Browder chart. These method are based on a 2-dimensional diagram and this is not the actual body. The lateral surface measurement is the affected limit by 2-dimensional diagram. In conventional method are no difference in diagram for each gender and BMI group. Women has more curves and shape and these are not estimated properly. The conventional method rely on the experience of the physicians. Selected participants are bought into 3-dimensional body scanner at the National Electronic and Computer Technology Center (NECTEC) ), Ministry of science and technology, in order to derive the 6 standardized 3- dimensional diagrams of total body figures. The scanner used in total body measurement is the same one that was used in the “Size Thailand” project by the government agency to determine the standard size of Thai citizens. From the disadvantages comes the new computerized program called the Thai 3d burn. This program is a co- development project between staffs at plastic & reconstructive surgical unit at Chonburi hospital and the staffs from faculty of engineering at Kasetsart University with the help from the size Thailand project at the NECTEC in developing a visual computerized diagram. 3D burn program for PC and notebook was establish since 2011. This program was first trial at Chonburi hospital. This 3D burn resuscitation mobile application was developed through collaboration from several institutions including Faculty of Medicine, Chulalongkorn University, Chonburi Hospital, Ministry of Public Health of Thailand, Faculty of Computer Engineering, Kasetsart University, NECTEC Thailand and granted by Operation Smile Thailand foundation. With this application, we can highlight any areas onto the model. There are 2 colors to select from. Blue represents a second degree burn and red represents a third degree burn. We can zoom and move this model all direction so any areas can be available to highlighted. Once the physician has finish label, the program will calculate and report % of burn surface areas by second and third degree in both numeric formats. The program will also suggest an appropriate amount of IV fluid resuscitation for the first 8 hours and the next 16 hours of burn treatment based on the Parkland-Formula. The good things about 3D model specification are , rotated all direction by one finger, zoom in zoom out by two finger, no limitation to curvy areas and lateral side , match to each gender and BMI groups, offline feature use, no additional equipment, paperless, and Free download. The 3D Burn Resuscitation Smartphone Application is available both in Apple's iOS and Google's Android. The application was study for validation by Singapore General Hospital. They operate the research in 2nd Singapore burn management update, September 2017. They conclude the result and publish in BMC (Biomed central) Burn and Trauma journal, February 2018. Various healthcare workers were invited to use both the 3D Burn application and the conventional methods to estimate the volunteer subjects burn percentages. The mobile application group is more accurate burn surface area measurements when compared to conventional methods. The aim of this study were to evaluate the precision of the 3D Burn application using by burn specialists and n0n-burn specialist physicians. In Thailand we complete the prospective, multi-center study at 3 center; Chulalongkorn Hospital Bangkok, Chonburi Hospital Eastern part and Chiangmai University Hospital North part. To evaluate the accuracy between general physicians who use the Rule of nines and 3D Burn application and burn specialist who use Lund Browder Chart and 3D Burn application. The burn area calculated by non-burn specialist physician using Rule of nine method was not much higher than other method from this graph but mean burn areas calculated by GPs using “Rule of nine” and “3D Burn resuscitation mobile application” were 25.98% and 22.13% respectively. Subsequently, mean burn areas recalculated by burn specialists using the application and LB were 21.71% and 22.31% respectively. ] 3D Burn resuscitation mobile application is a more precise and easier tool to calculate the burn surface area for physicians who are not burn specialists comparing to conventional method. Public Sector Exellence Award (PSEA) 2019 The Office of the Public Sector Development Commission (OPDC) Thailand Central Government Agency of the Royal Thai Government we have succeeded in developing the 3D burn application for pediatric patient. It is a tool for medical staff, making it easy to perform burn surface area estimation, and calculate resuscitation fluid and nutritional requirement. This time, 15 models of pediatric patients are collected from Thai patients in King Chulalongkorn Memorial Hospital and rendered to 3D model by The National Institute of Development Administration (NIDA). The IV fluid resuscitation has calculated from Parkland formula or ABA recommend. The body surface area has calculated from Dubois or Mostellar formula. The nutritional requirement has calculated from Galveston formula or modified Curreri formula 3D Burn Resuscitation (Adult) https://play.google.com/store/apps/details?id=com.mulberrysoft.BRF_Android&hl=th https://apps.apple.com/th/app/3d-burn-resuscitation/id1183128395 3D Ped Burn Resucitation (under 15yr) https://play.google.com/store/apps/details?id=com.NIDA3D.BURNResuscitation&hl=th https://www.hfocus.org/content/2017/05/13867?fbclid=IwAR1dAuHjiOpmzJmVw1AsHyyZBU_T1rHu-2s- 2upEOnVlkUcRoOcs3m0KaV8 https://play.google.com/store/apps/details?id=com.mulberrysoft.BRF_Android&hl=en https://www.facebook.com/Chonburi-Medical-3D-Printing-1666029550161316/?modal=admin_todo_tour https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828346/ https://www.youtube.com/watch?v=ZZ3EIYNra20&t=55s .
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