The Story Behind BurnMed

Back when Dr. Stephen Milner was serving in the Persian Gulf War as lieutenant colonel in the Royal Army Medical Corps, he was told to anticipate thousands of burn casualties.

There are specific guidelines for resuscitating burn victims. A clinician can calculate how much fluid patients need based on how long ago they were burned and the surface area of their burns.

Milner knew there was no way he could run the math for each patient on the spot, so he started working ahead. He simplified his calculations into two tables, which he quickly referenced as patients arrived.

In the end, the Milner didn’t see as many casualties as he expected, but the tables were so effective that he continued to use them.

“After the war, this was adapted for use in the civilian population, and we developed what was called a burn calculator,” Milner said.

This was the early inspiration for Johns Hopkins’ new app, BurnMed. Milner, director of the Johns Hopkins Burn Center, collaborated with Harry Goldberg, director of academic computing at Johns Hopkins School of Medicine, to create an app that teaches students, as well as lay people, how to stabilize a victim within the first eight hours after a burn.

Before the app, however, the burn calculator was a circular cardboard disk, and after that, the burn calculator was adapted for the palm pilot. It wasn’t until a fairly recent crisis that Milner was determined to create a more advanced tool.

In 2009 Deloris Jordan, mother of Michael Jordan and founder of the James R. Jordan Foundation, contacted Milner asking for his help after catastrophic fires near Nairobi, Kenya. JRJF was working with the Kenyan government as part of its ongoing effort to provide health care to women and children.

Milner and his team didn’t arrive in Nairobi until a week after the fires. He found that those who had treated the victims were capable and qualified clinicians, but they wanted to learn more about burn management.

“One of the goals of developing that app was to create a process by which we could train the lay person,” Goldberg said.

In addition to the calculator, BurnMed uses a combination of video, photos and text to provide a quick but thorough overview of how to handle burn victims. Goldberg said it took about seven months and six prototypes to figure out which modality to use to convey different information. For example, a one-minute video demonstrates an escharotomy, a surgical procedure used to relieve pressure and restore blood flow. Still images show how to recognize if an escharotomy is needed.

The app is part of Johns Hopkins’ larger mHealth initiative which involves collaboration among faculty members, students and staff to develop a range of medical apps. This was Goldberg’s team’s first mobile app, but he said he expects that it will be the first of many.

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