TraumAID: Reasoning and Planning in the Initial Definitive Management of Multiple Injuries

The TraumAID system has been designed to provide computerized decision support to optimize the initial definitive management of acutely injured patients after resuscitation and stabilization. The currently deployed system, TraumAID 1.0, addresses penetrating injuries to the abdomen and to the chest. Our experience with TraumAID 1.0 has demonstrated some major deficiencies in rule-based reasoners that are faced with problems of both diagnosis and treatment. To address these deficiencies, we have redesigned the system (TraumAID 2.0), factoring it into two modules: (1) a rule-based reasoner embodying the knowledge and logical machinery needed to link clinical evidence to diagnostic and therapeutic goals, and (2) a planner embodying the global knowledge and logical machinery needed to create a plan that addresses combinations of goals. After describing TraumAID 2.0, we discuss an extension of the TraumAID interface (critique mode interaction) that may improve its acceptability in a clinical setting. We close with a brief discussion of management support in resource-limited environments, which is an important issue in the time-critical context of multiple trauma.