BIPSR mTBI Request for Information

Title: Mild Traumatic Brain Injury (mTBI) Blast Injury Prevention Standards Request for Information

This Request for Information (RFI) is for information and planning purposes only and shall not be construed as a solicitation or as an obligation on the part of the Defense Health Agency Research and Development - U.S. Army Medical Research and Development Command (USAMRDC), headquartered at Fort Detrick, Maryland. The USAMRDC mission is to provide medical knowledge and materiel lifecycle management to protect, treat, and optimize service member health and performance across the full spectrum of operations. The Department of War (DoW) Blast Injury Research Coordinating Office (BIRCO) on behalf of the Executive Agent Responsible Official (EARO) coordinates the DoW-sponsored biomedical research programs aimed at preventing, mitigating, and treating blast-related injuries; recommends blast injury prevention standards; identifies knowledge gaps and shapes research programs accordingly; promotes information sharing among the operational, intelligence, medical, and materiel development communities; and facilitates collaborative research among DoW laboratories and the laboratories of other federal agencies, academics, and industry to leverage resources and to take full advantage of the body of knowledge that resides both within and outside of the DoW to accelerate the delivery of blast injury prevention and treatment strategies to Service members. BIRCO advises the EARO on Military Health System (MHS) Blast Injury Prevention and Treatment Standards for recommendation to the Office of the Assistant Secretary of War for Health Affairs [OASW(HA)]. To identify the best available standards that will meet the needs of the DoW, the BIRCO, in collaboration with The MITRE Corporation, employs the MHS Blast Injury Prevention Standards Recommendation (BIPSR) Process. The BIPSR Process is designed to address the needs of all Services for biomedically valid MHS Blast Injury Prevention Standards to protect against the entire spectrum of blast injuries. The process provides an unbiased, stakeholder-driven critical assessment methodology for identifying the best biomedically valid candidate, MHS Blast Injury Prevention Standards currently available. The term “Military Health System Blast Injury Prevention Standard” is defined as a “biomedically valid description of physiologically or biomechanically based injury and performance responses of a human to blast insults.” The standards can range from simple dose response curves and injury thresholds that address single components of blast insults, such as blast pressure wave magnitude, or address multiple components of blast insults, such as pressure magnitude over time. These standards will play a critical role in the prevention of service member injuries and the enhancement of service member survivability by informing health hazard assessments, survivability assessments, and protection system development aimed at producing safe weapon systems, survivable combat platforms, and effective protection systems.To conduct these assessments, the DoW needs MHS Blast Injury Prevention Standards to investigate the physiological and biomechanical effects of blast injuries on the Warfighter, such as when generated by enemy explosive weapons and when produced by blast exposures during weapon systems firing. For the purposes of this RFI, Blast Injury is defined as an injury that occurs as the result of the detonation of high explosives, including vehicle-borne and person-borne explosive devices, rocket-propelled grenades, and improvised explosive devices. The taxonomy of injuries from blast explosive devices is comprised of: (a) Primary: Blast overpressure injury resulting in direct tissue damage from the shock wave coupling into the body; (b) Secondary: Injury produced by primary fragments originating from the exploding device (preformed and natural (unformed) casing fragments, and other projectiles deliberately introduced into the device to enhance the fragment threat); and secondary fragments, which are projectiles from the environment (debris, vehicular metal, etc.); (c) Tertiary: Displacement of the body or part of the body by the blast overpressure causing acceleration/deceleration to the body or its parts, which may subsequently strike hard objects and suffer typical blunt injury (translational injury), avulsion (separation) of limbs, stripping of soft tissues, skin speckling with explosive product residue, and building structural collapse that results in crush and blunt injuries or crush syndrome development; (d) Quaternary: Other ”explosive products“ effects - heat (radiant and convective) and toxic (toxidromes from fuel, metals, etc.) - causing burn and inhalation injury; (e) Quinary: Clinical consequences of ”post-detonation environmental contaminants“ including bacteria (deliberate and commensal, with or without sepsis), radiation (dirty bombs), tissue reactions to fuel, metals, etc.