In an effort to treat wounded soldiers as fast as possible, the US Department of Defense has awarded four-year contracts worth a total of US$7.2 million to the University of Pittsburgh School of Medicine (UPMC) and Carnegie Mellon University (CMU) to develop an autonomous trauma care system that can fit in a rucksack. Called TRAuma Care In a Rucksack (TRACIR), it will use advanced sensors, robotics, and artificial intelligence to autonomously treat battlefield casualties almost immediately.

In trauma surgery there is what is called the "golden hour." More a metaphor than a strict medical term, it encapsulates the idea that stabilization and treatment of a trauma patient in the brief window after receiving an injury can mean the difference between life and death. So important is this concept, that it has informed decades of military and civilian doctrines about treating casualties.

According to CMU, the purpose of TRACIR is to reduce the time a patient receives treatment down to almost the point they are placed on a stretcher. Drawing on the expertise of a multidisciplinary team of Pitt researchers and clinicians from emergency medicine, surgery, critical care and pulmonary fields combined with that of roboticists and computer scientists at CMU, the goal is to build a "hard and soft robotic suit" into which a patient can be inserted.

Inside this "suit" is an array of sensors through which a series of computer algorithms can assess the condition of the patient and robotically provide the appropriate treatments, including medicines and intravenous fluids. Through the use of machine learning, TRACIR can help to resuscitate, stabilize, and treat soldiers as they are evacuated from the battlefield to proper medical facilities, or even in the field if evacuation isn't possible or a medic isn't available.

"Everybody has a slightly different vision of what the final system will look like," says Artur Dubrawski, research professor at CMU's Robotics Institute. "But we see this as being an autonomous or nearly autonomous system – a backpack containing an inflatable vest or perhaps a collapsed stretcher that you might toss toward a wounded soldier. It would then open up, inflate, position itself and begin stabilizing the patient. Whatever human assistance it might need could be provided by someone without medical training."

It's an ambitious project and one that the team says must progress by "a series of baby steps" as individual components are developed and the technology created to handle such tasks as inserting an IV needle in a vein or installing a chest tube. Part of this will involve algorithms that will draw on a digital library of over 5,000 UPMC trauma patients that will help TRACIR to learn how to identify if a patient is growing worse and administer the appropriate treatment. But it's not just soldiers wounded in the line of duty that stand to benefit from such technology.

"TRACIR could be deployed by drone to hikers or mountain climbers injured in the wilderness; it could be used by people in submarines or boats; it could give trauma care capabilities to rural health clinics or be used by aid workers responding to natural disasters," says Dubrawski. "And, someday, it could even be used by astronauts on Mars."

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