2. Military Robotic Combat Casualty Extraction and Care

Buddy treatment, first responder combat casualty care, and patient evacuation under hostile fire have compounded combat losses throughout history. Force protection of military first responders is complicated by current international and coalition troop deployments for peacekeeping operations, counter terrorism, and humanitarian assistance missions that involve highly visible, politically sensitive, low intensity combat in urban terrain. The United States Department of Defense (DoD) has significantly invested in autonomous vehicles, and other robots to support its Future Force. The US Army Telemedicine and Advanced Technology Research Center (TATRC) has leveraged this DoD investment with augmented funding to broadly focus on implementing technology in each phase of combat casualty care. This ranges from casualty extraction, physiologic real-time monitoring, and life saving interventions during the “golden hour” while greatly reducing the risk to first responders.

The TATRC portfolio of projects aims to develop, integrate, and adapt robotic technology for unmanned ground and air battlefield casualty extraction systems that operate in hostile environments that include enemy fire. Work continues on multiple ground extraction systems including a prototype dynamically balanced bipedal Battlefield Extraction Assist Robot (BEAR) capable of extracting a 300–500 pound casualty from a variety of rugged terrains that include urban areas and traversing stairs. The TATRC and the Defense Advanced Research Projects Agency (DARPA) are collaborating to investigate the use of Unmanned Aircraft Systems (UAS) to conduct casualty evacuation (CASEVAC) missions. TATRC has also sponsored research in robotic implementation of Raman and Laser-Induced Breakdown Spectroscopy (LIBS) to detect and identify potential chemical and biological warfare agents and explosive hazards to casualties and first responders during the extraction process, and patient monitoring equipment with sophisticated telemedicine and patient monitoring equipment such as “smart stretchers” that allow for real-time physiologic monitoring throughout the combat casualty care process, from extraction to definitive care. Other projects are intended to build upon these monitoring systems and incorporate telerobotic and near autonomous casualty assessment and life saving treatment to the battlefield. These have included the DARPA Trauma Pod and several TATRC efforts to integrate robotic arms with the Life Support for Trauma and Transport (LSTAT) litter for robotic implementation of non-invasive technologies such as acoustic cauterization of hemorrhage via High Intensity Focused Ultrasound (HIFU). Several projects have explored the essential telecommunication link needed to implement telesurgery and telemedicine in extreme environments. UAS were leveraged to establish a telecommunication network link for telemedicine and telesurgery applications in extreme situations. Another collaborative telesurgery research project at the NASA Extreme Environment Mission Operations (NEEMO) included performing telesurgery in an undersea location.

Research into identification and solutions of the limitations of telecommunication and robotics that prevent robust casualty interventions will allow future medical robots to provide robust casualty extraction and care that will save the lives and limbs of our deployed warfighters.