Extending the Golden Hour for Enhanced and Timely Combat Care

Severe combat injuries require surgical care as soon as possible to avoid loss of life. The Department of Defense refers to the critical initial 60 minutes as the “golden hour,” in which medical care offers the highest likelihood for successful intervention. However, the realities of combat mean the established practice of rapid evacuation for care at a surgical facility may be unavailable during that critical window.

Solutions currently exist to provide extensive casualty care outside of surgical facilities, but these require an expert team to continuously manage the patient and essential devices such as resuscitation fluid pumps and ventilators. Further, the solutions are constrained by bulky hardware ill-suited for use on, or adjacent to, the battlefield.

DARPA’s GOLDen hour extended EVACuation, or GOLDEVAC, program aims to test whether a field medic could manage a complex polytrauma patient via automated resuscitation tools, starting near the point of injury and continuing throughout the entire evacuation process. Specifically, GOLDEVAC seeks to determine whether it is possible to resuscitate and oxygenate a patient, for up to two days, via a single tube inserted into a patient’s blood vessel, without the risk of blood clots or bleeding. This single intravascular interface must be relatively small and suitable for insertion by field medics, while providing the physical interface to monitor and manage the critically injured patient. If successful, GOLDEVAC could provide a medical force multiplier that could enhance the Department of Defense’s ability to successfully care for critically injured service members, across the spectrum of mission sets – from small remote missions through large-scale conflicts against peer / near peer adversaries.

“Historically, U.S. warfighters have had access to medical infrastructure providing access to relatively rapid evacuation and then medical intervention, but we anticipate such infrastructure will be lacking in future conflicts,” said GOLDEVAC program manager LtCol Adam Willis. “GOLDEVAC is designed to bridge the gap and ensure patients can be safely and effectively stabilized from near point of injury and throughout the entire medical evacuation process.”

Throughout the program, performers will have opportunities to engage with multiple government agencies in support of technology transition, to ensure that viable GOLDEVAC systems will have a pathway to military adoption, commercialization, or both. Performers will engage with appropriate regulatory authorities, including the U.S. Food and Drug Administration to meet or exceed safety standards. Teams may be required to meet with ethical, legal, and societal implications experts to ensure the research addresses any related concerns.

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