UK Field Medical Care 2032: one Military Vision

• Published in: BMJ military health 2023-12, Vol.169 (6), p.485-487
• Main Authors: Parker, Paul, Pynn, H, Haldane, A G, Ballard, M, König, T C, Johnston, A M
• Format: Article
• Language: English
• Subjects: Abdomen; accident & emergency medicine; Algorithms; Anesthesia; Antibiotics; Artificial intelligence; Automation; Blood; blood bank & transfusion medicine; Editorial; Head injuries; health policy; Hemodialysis; Hospitals; neurosurgery; radiology & imaging; Robotics; Trauma; trauma management; Ultrasonic imaging
• ISSN: 2633-3767; 2633-3775
• DOI: 10.1136/bmjmilitary-2021-002056

A robot arm applies a platelet impregnated antimicrobial dressing.2 Ultrasound-guided needle systems cannulate her arm3 and infuse a clean fresh whole blood cell and plasma substitute, the on-board water reservoir begins to make spare infusion fluid from stored local rainwater.4 Antibiotics, cross-checked automatically against the e-dog tag chip in her neck for allergies are given. In the event of facial injuries or mask apprehension; given its on-board environment control system, the drone can increase the oxygen concentration within its sealed passenger compartment to 35% and release aerosolised opioid analgesics. The casualty’s data show a genetic variant suggesting they will be abnormally sensitive to morphine, perhaps increasing the already high risk of delirium during recovery.30 An alternative painkiller acting on sodium channels is readied for when the drone arrives at the R2 hospital with the patient.31 With the airway at risk of compromise, the emergency physician now intubates the casualty, while the intensivist prepares the AI-driven mechanical ventilator, its algorithm designed to reduce the risk of lung injury and subsequent organ failures.32 The intensivist now places a continuously reading arterial line, which samples a wide range of parameters in close to real time, including blood haemoglobin concentration, electrolytes and markers of adequate resuscitation such as lactate. Head injury care or neuroprotection (ie, prevention of any secondary brain damage) during the next few days will be critical, but relies on simply maintaining most parameters such as body temperature and blood chemistries at normal levels.35 The larger Role 3 hospital ECLS systems are predominantly aimed at keeping casualties alive if they have severe lung injury from enhanced blast munitions or lung damaging chemical, biological radiation and nuclear agents until the lungs recover.36 At Combat Team Headquarters, the automated casualty management system has already logged that the casualty is en route, updates the current vital signs and assigns a ‘Seriously Ill’ status to the casualty.