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Development of Autonomous Medical Systems for Tactical Evacuation

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Human Factors and Medicine

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Autonomous Systems, Autonomy, Casualty Evacuation, Closed Loop Technologies, Combat Casualty Care, Enroute Care, Medical, Patient Transport, Robotics, Tactical evacuation, UAS, UAV, UGV, Unmanned Systems


Unmanned Aerial Systems (UAS) and Unmanned Ground Vehicles (UGV) are being developed to support logistics operations in future operating environments where resources are constrained due to environmental conditions or adversary threats. These unmanned vehicles have the potential to add capacity to medical forces when conventional medical assets are overwhelmed or otherwise unavailable. In the future, Commanders will employ UAS as force multipliers for medical operations to include medical logistics support (e.g. medical resupply/delivery of blood products), aid in the delivery of telehealth/teleconsultation to the point of care, and expedited casualty evacuation in support of Prolonged Field Care or when immediate evacuation is not possible with manned assets. Past NATO activities have provided the foundation for the development of unmanned vehicle capabilities to support medical missions including the NATO STO TR-HFM-184 “Safe Ride Standards for Casualty Evacuation Using Unmanned Aerial Vehicles” and the NATO Allied Medical Publication (AMedP-37) “Development and Implementation of Teleconsultation Systems” (STANAG 2517). Emerging military doctrine and strategies envisions so called “multidomain battle” concepts characterized by widely dispersed, autonomous maneuver elements, potentially separated from main forces. This concept has prompted emergence of concepts for prolonged field care when evacuation is delayed or unavailable. Lack of experienced providers at the point of injury in such far forward environments is potentially a critical gap for dispersed battlefield scenarios. Accordingly, the need for expert medical knowledge to manage tactical evacuation patients for extended periods of time, often in the absence of “reach-back” telecommunications for telementoring or teleconsultation will be key to minimizing mortality and morbidity rates of future combat casualties. Similarly, the need to move tactical evacuation patients, absent medical attendants, with ad equated enrooted care from the point to injury to a point where definitive medical care can be administered is also a major concern. Currently, there are several research efforts underway in many countries to develop new concepts for automated care of tactical evacuation patients. These efforts focus on development of new devices, algorithms, and concepts that will allow providers taking care of stable and unstable trauma patients to off-load management of certain procedures to an automated system (computer-based interventions) and range from simple advanced human factors research (e.g. new approaches to display multiple data streams for better interpretation by users), to advanced active actuator controlled closed-loop devices that monitor, decide, and act to manage specific interventional procedures (e.g. blood pressure control through fluid and drug hemodynamic interventions). Similarly, as patients require continual monitoring through the different military levels of care, the need to automate the transport and evacuation of these patients in many different environments is also becoming increasingly important. Developing the capability to move patients and materiel using autonomous ground and/or air assents has been identified as a critical gap to address expected shortages of supplies, equipment, and personnel in current and future environments. Several research efforts are under way to develop autonomous platforms to move personnel and equipment in many different ground and air environments. However, there needs to be a concerted effort to develop the capability to support autonomous transport of injured patients that will required additional monitoring and life-saving systems to operate simultaneously with automated vehicle systems and provide a comprehensive solution moving personnel in various scenarios


1) Establish common NATO concepts for leveraging emerging general purpose unmanned systems (UMS) platforms for medical missions such as autonomous ground and air patient evacuation and delivery of emergency medical supplies and for employment of robotic, autonomous, and unmanned capabilities to support forward combat casualty care and enroute care during evacuation on such platforms. 2) Establish a common NATO research and development roadmap for robotic, autonomous, and unmanned capabilities in support of combat casualty care and establish procedures for coordinating research and development among NATO members. 3) Develop methods and approaches for implementing safe ride standards on emerging autonomous platforms for patient transport as outlined in NATO TR-HFM-184. 4) Survey and select interoperability standards and develop methods to allow medical equipment to communicate over allied command and control networks when used onboard autonomous platforms. 5) Define mission planning capabilities required to effectively coordinate patient transport across allied forces that includes using unmanned systems as vehicles of opportunity for casualty evacuation.


1) Emerging general purpose unmanned systems platforms for medical missions such as autonomous ground and air patient evacuation and delivery of emergency medical supplies 2) Automated patient monitoring and closed-loop interventions to enhance enroute care capabilities for patient transport via unmanned systems. 3) Medical Aspects of Manned-Unmanned Teaming (MUM-T) to develop medical performance criteria to ensure Warfighters have the physical, cognitive, and psychological capacity to effectively team with robotics and autonomous systems. 4) Interoperability standards for interfacing medical systems with general purpose unmanned systems platforms across allied nation stakeholders.

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