Ohio State startup expands disaster training with pediatric simulation

A new virtual reality simulation developed by an Ohio State University startup is helping first responders practice treating children and adults injured when a tornado strikes a day care center. 

Tactical Triage Technologies’ new scenario requires users to assess injuries and determine which patients need care first. It addresses a challenge in disaster preparedness: giving responders opportunities to practice treating children when live exercises often rely on adult participants. 

“Training for disasters involving children is really tough to do,” said Dr. Nicholas Kman, an emergency physician at The Ohio State University Wexner Medical Center and the company’s founder. 

The pediatric simulation is part of the company’s effort to expand training for emergencies that responders may rarely encounter but must be prepared to manage. Another scenario in development will focus on a sudden influx of patients into an emergency department, requiring users to prioritize and direct care. 

Kman said large disaster drills provide valuable experience, but participation can depend on whether responders are working that day. Virtual reality offers opportunities to practice those decisions more frequently. 

“These are low frequency but high acuity, high stress events,” he said. “And training for these things is just tough to do.” 

Users enter a virtual scene through a headset, assess patients and make treatment decisions. Afterward, they receive a report on their performance. The simulations cover tasks such as controlling bleeding, managing airways and deciding which patients should be evacuated first. 

The technology runs on a commercially available Meta Quest 3 headset. Artificial intelligence enables virtual patients to respond to questions and instructions, such as identifying where they are hurt or following a request to lie on their backs, Kman said. 

The work began at Ohio State in 2018 with a grant from the Agency for Healthcare Research and Quality. Researchers from the College of Medicine collaborated with the College of Arts and Sciences Advanced Computing Center for the Arts and Design to build a virtual reality training module depicting a subway bombing with multiple casualties. 

The team used the technology to train local emergency responders and participants at national conferences. Interest in commercialization grew in 2023, and Ohio State’s commercialization office helped Kman establish Tactical Triage Technologies in February 2025. 

Fire departments, hospitals and other organizations can license the technology or work with the company to receive training. 

The Ohio State technology also became part of work funded through the Defense Advanced Research Projects Agency’s In the Moment program in 2023. Those simulations allow researchers to study how combat medics and other military first responders make decisions, Kman said. 

His approach to training draws on his own disaster response experience. As a physician with Ohio Task Force One, a Federal Emergency Management Agency urban search and rescue team, Kman has deployed to hurricanes including Harvey, Ian, Helene and Milton. 

He has also heard how the training translated to an actual emergency. An emergency response agency that participated in the Ohio State team’s training later responded to a bus crash involving a marching band. Responders told Kman afterward that the experience helped them think through caring for multiple patients with burns and traumatic injuries. 

For Kman, that feedback connects the technology’s development to the company’s purpose. 

“Ultimately what Tactical Triage Technologies’ goal is, is saving lives,” he said.