STTR: Medical Swarm Robotics for Extraction and Life-Saving Interventions

OUSD (R&E) critical technology area(s): Biotechnology, Human-Machine Interfaces, Trusted AI and Autonomy, Biomanufacturing

Objective: Develop and demonstrate small-robotic swarms capable of autonomous battlefield medical assistance, including short casualty movement, hemorrhage control, fracture stabilization, and medication delivery.

Description: This topic addresses a critical battlefield medical need through the development of innovative swarm-based small-robotic systems capable of autonomous medical assistance to incapacitated and difficult to reach casualties. Future Large Scale Combat Operations (LSCO) predict massive casualty incidents, delayed evacuation, and insufficient capacity of the medical system, especially from the point-of-injury to Role 1 medical care [1]. With a delayed medical response casualties have a high chance of dying due to lack of hemorrhage control which is the leading cause of potentially survivable death in both battlefield and civilian trauma cases prehospital [2,3]. Autonomous medical care may be essential for saving lives in these future contexts, especially for casualties who are unable to treat themselves, have no buddy aide in proximity, or are in inaccessible areas for human medical response. This topic calls for a solution of an autonomous, self-deploying, wound assessing, swarm-capable, self-linking, mobile robotic solution to assist reaching and moving casualties and perform life-saving interventions (LSIs) at the point-of-need. Small swarm robotics provide advantages in their ability to access difficult to reach casualties obscured by rubble and terrain, can adapt by conjoining or detaching to meet the need of a detected casualty, and are ideal for limited space during unmanned evacuation assistance. We believe this is achievable due to the recent advancements in swarm, self-assembling, and mobile robotics, as well as robotics for medical applications [4–7]. For this topic, the novel robotic system should demonstrate at least two of the following four essential capabilities, one form each category:

Extraction:

1. Movement of a casualty a short distance (10m) and/or onto a SKED or litter
2. Stabilization of a fractured limb through the entanglement of rigid structures

Treatment:

1. Manage massive extremity or junctional hemorrhage control
2. Delivery of medications through intramuscular injection or placement of intraosseous needle

First, a solution can demonstrate the ability to leverage a swarm architecture to coordinate the capability to drag/move a casualty a short distance and or position the casualty onto an extraction SKED or litter. Coordinated swarm maneuvers would allow smaller robotics capable of navigating tight spaces lift or drag a casualty together when a single unit may not have the dragging capacity otherwise.

Second, a solution can demonstrate protective limb stabilization by entangling multiple robotic units around or along a limb. By interlocking systems, a solution should provide protective bracing around an injured body-part to prevent further injury during casualty movement.

Third, a solution can demonstrate the ability to self-arrange and reassemble into shapes to provide massive hemorrhage control. The goal will be to create a “smart tourniquet” capable of autonomously clamping around injured limbs to stop arterial blood flow as well as apply sufficient pressure and coverage over a junctional wound. The solution will need the necessary sensing and intelligence to identify and locate the hemorrhage injury and advanced capabilities and swarm architecture to reassemble into a hemostatic tool.

Fourth, a solution can demonstrate the ability to deliver medications to a casualty either through intramuscular injection or establishing an intraosseous infusion. Due to the intended smaller size, the medical robotic solution could be an ideal assistant in the tight quarters of unmanned evacuation vehicles. The ability to provide medications and fluids enables higher qualities of care by autonomous and unmanned systems.

The proposed design for a robotic solution should aim to accomplish two of the four tasks with at least one from each category of extraction and treatment while being as small, light, and portable as possible. Proposals that can accomplish more tasks will be reviewed more favorably. The topic is not prescribing a design choice, and proposers are welcome to propose any form factor of robotic system that provides mobility, a swarm architecture, and self-assembly and deployment. The desired utilization of these robots is for individual/self-aid in a frontline environment with the aim to fit into an Individual First Aid Kid (IFAK) or lightweight enough to be deployed via drone-swarm. By leveraging a modular, interconnected, swarm-capable architecture the design should allow for mobility across dynamic environments, adaptability to various anatomies and injuries, and low-cost manufacturing.

Phase I

Proposals are required to have selected design targets prior to Phase I acceptance, i.e., Phase I is not an exploratory phase into multiple designs. Phase I will include development of subcomponents of the design to demonstrate feasibility into the overall Phase II proposed solution. While not necessary to be integrated into a fully realized prototype system, Phase I will require the demonstration into feasibility of the following system subcomponents: 1) a modular swarm architecture and communication capability, 2) sensing capability to identify injury and anatomy, 3) mobility of the units across dynamic terrain and over/across the human body, 4) design feasibility into achieving treatment capabilities, 5) design feasibility of interlocking units, shape-changing, & rigid stability. Demonstrations can be conducted in lab environments and on hemorrhage control trainers / patient manikins. Deliverables in Phase I include reports and video demonstrations when milestones are made.

Milestones

• Month 1: Design, build, test, and learn plan
• Month 3: Mid-point subcomponent design review
• Month 6: Subcomponent feasibility demonstrations

Key Deliverables

• Month 1: Design, build, test, and learn plan
• Month 3: Mid-point design review report
• Month 6: A comprehensive subcomponent feasibility report and demonstrations (videos) of functional subcomponents:
  1. Modular swarm architecture and communication capability
  2. Mobility of units across dynamic terrain and over/across the human body
  3. Ability to identify injury and anatomy
  4. Feasibility into design to achieve treatment capabilities
  5. Feasibility into design of interlocking units, shape-changing & rigid stability

PHASE II

Phase II requires proposers to develop a fully realized physical prototype of the swarm-capable small robotic system and demonstrate its ability to perform the four listed medical interventions on high-fidelity phantoms in operationally relevant environments. All developed subcomponents developed under Phase I will be advanced and integrated into features of a realized system. Advancements must be made to the components throughout Phase II to enable more effective capability in LSIs, and ruggedization towards fielding the technology. Sensing capabilities will need to be added to understand if proper tourniquet application has been made across varying limb sizes. Proposers must also develop sensing capabilities to ensure proper pressure is applied to wounds and monitoring if hemostasis is achieved. Additionally advanced interlocking strategies to stabilize fractures must be developed.

At the conclusion of Phase II a physical demonstration must be conducted of the proposed solution autonomously accomplishing two of the four medical interventions by leveraging its swarm architecture and self-reassembling capabilities. Performers must physically demonstrate one procedure from each of the following categories:

Extraction:

1. Movement of a casualty a short distance (10m) and/or onto a SKED or litter
2. Stabilization of a fractured limb through the entanglement of rigid structures

Treatment:

1. Manage massive extremity or junctional hemorrhage control
2. Delivery of medications through intramuscular injection or placement of intraosseous needle

Demonstrations must be conducted in operationally relevant environments on either perfused cadavers, animal models, or high-fidelity medical training phantoms. The system by the end of Phase II must be ruggedized to operate outdoors and in unideal weather conditions. Phase II will also require commercialization and transition planning along with technology development. Throughout the phase, the proposers must collaborate with military end-users to refine operational requirements and deployment scenarios of their developed solution. Manufacturing and scaling plans for production must also be developed before the end of the Phase including designing packaging and deployment systems for rapid battlefield deployment. Since this is a medical device intended to interact with people, an FDA acceptance plan must be developed in Phase II involving a regulatory pathway and protocols for safe operation. The final report must also include technology transfer documents outlining planned opportunities for commercial and military applications.

The deliverables for Phase II will include the ruggedized final prototype system consisting of multiple modular units with integrated enhanced capabilities, a comprehensive testing and validation report outlining the final demonstration, the technology transfer plan with commercialization plans, FDA regulatory pathway, and manufacturing and scaling strategy.

Milestones

• Month 1: Design, build, test, and learn plan
• Month 6: Fabrication of all necessary subcomponents
• Month 9: Physical testing of subcomponents and subcomponent capabilities
• Month 12: Integrated prototype
• Month 15: Successful demonstration of Extraction task with integrated prototype
• Month 18: Successful demonstration of Treatment task with integrated prototype

Key Deliverables

• Month 1: Design, build, test, and learn plan
• Month 6: Report of subcomponent fabrication
• Month 9: Video demonstration of subcomponent testing
• Month 12: Report and design documentation of integrated prototype
• Month 15: Video demonstration of Extraction task with integrated prototype
• Month 18: Video demonstration of Treatment task with integrated prototype. Comprehensive report including: testing and validation reports, technology transition plan with commercialization pathway with description of integration specifications for existing military medical systems, and discussion of manufacturing and logistics framework for production scaling.

Phase III dual use applications

Phase III offers the opportunity for the proposers to apply secured outside funding, not from the SBIR program, to advance and mature the technology further for commercial and Government use cases. Many commercial applications could be applied for an advanced swarm-like medical response system specifically in disaster response. Collapsed buildings, fires, and hazardous chemicals can make reaching civilian casualties impossible outside of the means of robotic and autonomous systems. Initial LSIs can provide the necessary time for stabilization until medical response teams arrive and continue care. For the military there are expectations that LSCO environments will put a strain on the current doctrine of casualty response time and alternative and advanced solutions must be applied to manage massive hemorrhage. Possible military transition partners could include Project Manager Soldier Medical Devices (PMSMD) or Program Executive Office Operational Medicine (PEO OpMED).

References

1. Remondelli, M. H.; Remick, K. N.; Shackelford, S. A.; Gurney, J. M.; Pamplin, J. C.; Polk, T. M.; Potter, B. K.; Holt, D. B. Casualty Care Implications of Large-Scale Combat Operations. J. Trauma Acute Care Surg. 2023, 95 (2S), S180–S184. https://doi.org/10.1097/TA.0000000000004063.
2. Eastridge, B. J.; Mabry, R. L.; Seguin, P.; Cantrell, J.; Tops, T.; Uribe, P.; Mallett, O.; Zubko, T.; Oetjen-Gerdes, L.; Rasmussen, T. E.; Butler, F. K.; Kotwal, R. S.; Holcomb, J. B.; Wade, C.; Champion, H.; Lawnick, M.; Moores, L.; Blackbourne, L. H. Death on the Battlefield (2001–2011): Implications for the Future of Combat Casualty Care. J. Trauma Acute Care Surg. 2012, 73 (6), S431–S437. https://doi.org/10.1097/TA.0b013e3182755dcc.
3. Davis, J. S.; Satahoo, S. S.; Butler, F. K.; Dermer, H.; Naranjo, D.; Julien, K.; Van Haren, R. M.; Namias, N.; Blackbourne, L. H.; Schulman, C. I. An Analysis of Prehospital Deaths: Who Can We Save? J. Trauma Acute Care Surg. 2014, 77 (2), 213–218. https://doi.org/10.1097/TA.0000000000000292.
4. ) Peck, R. H.; Timmis, J.; Tyrrell, A. M. Self-Assembly and Self-Repair during Motion with Modular Robots. Electronics 2022, 11 (10), 1595. https://doi.org/10.3390/electronics11101595.
5. Chong, B.; He, J.; Irvine, D.; Wang, T.; Flores, E.; Soto, D.; Lin, J.; Xu, Z.; Nienhusser, V. R.; Blekherman, G.; Goldman, D. I. Robust Control for Multi-Legged Elongate Robots in Noisy Environments. arXiv 2025. https://doi.org/10.48550/ARXIV.2506.15788.
6. Yin, S. Artificial Intelligence-Assisted Nanosensors for Clinical Diagnostics: Current Advances and Future Prospects. Biosensors 2025, 15 (10), 656. https://doi.org/10.3390/bios15100656.
7. Silvera-Tawil, D. Robotics in Healthcare: A Survey. SN Comput. Sci. 2024, 5 (1), 189. https://doi.org/10.1007/s42979-023-02551-0.

Keywords

Swarm robotics, battlefield medicine, autonomous systems, hemorrhage control, smart tourniquet, medical robotics, entanglement dynamics, medical automation, emergency response, combat casualty care.

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