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Impact of Gender Variation on Casualty Treatment and Training

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Human Factors and Medicine

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anthropometry, biomechanics, casualty, Female, gender, injury, modelling, training


As of 2014, between 11 % and 14.6% of active-duty military force was comprised of females. Although women have typically been excluded from combat roles in the past, females played a prominent role in conflicts over the past ten years. Data from literature show that military female casualties are far more likely to die after wounds than males, in contrast with civilian reports of females demonstrating higher survival rate than males with comparable injury. In fact, data from the US Joint Theatre Trauma Register showed that female casualties presented with a greater proportion of abdominal injuries, and tended to have more chest injuries than their male counterpart who survived. Specifically, in a study of sucking chest wounds and other traumatic chest injuries, data showed that when assessed by gender, the Needle Chest Decompression procedure had a higher success rate in males than females. Current simulation based training is male centric. The absence of a gender-specific simulation model used for practicing lifesaving procedures, cultural norms in conjunction with ingrained societal taboos, induces medical personnel to react differently to immediate medical needs of female patients in emergency situations. Furthermore, the inherent variability of the human anatomy precludes the use of average geometries when developing population-representative human models (e.g., gender-specific). For the purpose of human modelling for injury prediction or medical training, models must ideally account for internal differences that exist due to patient demographics (e.g., race, age, gender) and/or external physical anthropometry (e.g., height and weight). Along this vein, allometry is a method for identifying how an organism’s internal anatomical structures scale with its overall size, which is important when accounting for anatomical variation affecting intervention planning for emergency procedures.


The main objective is to enhance training of military medical personnel in the treatment of female casualties in order to increase the probability of survival in the battlefield, by means of improving gender-specific modelling and developing an effective simulation. Such enhanced capability should support current training objectives of casualty care in Program of Instruction (POI) worldwide. Taking into account that current models are primarily male-centric, there is a specific and genuine need to develop anatomically and physiologically correct female simulation-based models.


The main scientific topics addressed by this study are: • Assessment of state of the art techniques and data for creating female models and mannequins; • Definition of gaps in current modelling and simulation techniques; • Female modelling (allometry, anthropometric/biometric, soft tissue); • Injuries and gender-specific treatments; • Definition of mannequin and virtual model requirements;

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