TRIAGE-X | SBIR

OUSD (R&E) critical technology area(s): Advanced Computing and Software, Biotechnology, Human-Machine Interfaces, Integrated Sensing and Cyber, Trusted AI and Autonomy

Objective: Develop and demonstrate capability with autonomous medical triage systems to recognize chemical toxidromes and physically deliver the corresponding antidote or life-saving intervention.

Description: DARPA seeks innovative approaches to autonomous chemical, biological, radioactive, and nuclear (CBRN) triage that measurably improve casualty survival and increase the effective capacity of a medical response during CBRN disasters. Early situational awareness and timely treatment is a matter of life and death in battlefield and disaster medical triage. Responder vulnerability in hazardous environments caused by CBRN attacks adds significant difficulty to the medical response. When a mass casualty incident (MCI) occurs within a chemically contaminated area, the medical response is hindered by uncertainty while the threat is assessed and characterized. To ensure safety of the responders, they must don protective equipment before entry, delaying initial assessment, triage, and treatment with life-saving interventions (LSIs). Personal protective equipment (PPE) also imposes a physiological and functional penalty on responders resulting in slower movement, higher energy expenditure, heat stress, impaired respiration, and reduced manual dexterity; these penalties further impede responders’ ability to perform life-saving interventions. Effective stabilization occurs in the cold zone after casualties have been decontaminated [1,2], compounding the delay to evacuation and definitive care.

The DARPA Triage Challenge (DTC) has demonstrated that autonomous air and ground systems, using standoff sensors, can locate casualties, characterize injury patterns, and support triage prioritization in realistic MCI conditions [3]. Using DTC triage support capabilities as a starting point, this solicitation aims to extend capabilities to operating in chemically hazardous environments where injury patterns have distinct signatures or toxidromes. Success here extends proven autonomous triage into one of the most challenging settings where human entry is dangerous and delayed, and where early antidote delivery most directly determines casualty survival [4].

Proposed systems should be able to locate and assess casualties for traumatic injuries and chemical toxidromes, generate triage recommendations, and deliver appropriate initial treatments to reverse, stabilize, or prevent the toxic effects of chemicals. Solutions should be designed for realistic operational use in difficult terrain under challenging environmental conditions. DARPA does not prescribe a specific platform, sensor suite, or level of autonomy. Offerors are encouraged to propose the human-machine teaming arrangement that best improves decision quality and casualty outcomes, and to define how their system fails safely when conditions exceed its competence. Approaches should be realistic in scope, repurposed within the period of performance, and grounded in how CBRN mass casualty response actually unfolds.

At minimum, the effort shall deliver a demonstrated prototype that detects at least two representative chemical toxidromes and applies appropriate initial treatments for the assessed toxidrome following human-in-the-loop treatment approval.

Phase I

This topic is soliciting Direct to Phase II (DP2) proposals only. Phase I work is expected to have been completed before award. Proposers must submit evidence that their existing prototype can:

• Autonomously find and localize casualties and report their location to within 2m
• Assess trauma patterns and assign a trauma triage category
• Perform accurate standoff vital-signs assessment, including at minimum heart rate and respiratory rate
• Operate at scale
  • At least 20 casualties in a single scenario
  • Perform assessment in <90 seconds for each casualty
  • Survey a 30,000sqft area without battery change
• Operate across diverse, realistic environments: indoor and outdoor, daytime and nighttime, ideally (but not required) in adverse weather conditions (rain, smoke)
• Produce a human-interpretable output through a graphical interface that conveys casualty locations and priorities of care.
• System must be portable. All components should be easily transported by a vehicle or drone.

Capability demonstration:
A written technical description or published report supported by data and video(s) demonstrating the prototype performing the capabilities above in the stated environments are required (provided via link).

Phase II

Building on the feasibility demonstrated in the documentation above, the Phase II effort will extend their qualified baseline system to assess and treat chemical toxidromes. In this effort, performers will develop, integrate, and validate a prototype autonomous chemical casualty triage system and demonstrate it in a relevant environment. The system shall identify casualties, assess them for life threatening and other traumatic injuries, assess casualties for chemical toxidromes, and provide relevant physical treatments.

Requirements: Performers shall develop the capability to assess and treat at least two chemical agent categories from Table 1. Agent detection is out of scope for this effort. Treatment recommendations and options for each casualty shall be presented through a graphical interface to responders. Treatment decisions will always be made by humans.

Performers will demonstrate their platform’s ability to recognize simulated toxidromes in silico (computer-based simulation) and on high-fidelity mannikins with the simulated toxidrome presentations outlined in Table 2.

Performers will demonstrate their platform’s ability to assess and deliver interventions on simulated casualties in both computer-based simulation or on physical manikins/in physical environments as outlined in Table 3. Some tasks that *must* be demonstrated on a physical manikin or in Table 3.

Phase III dual use applications

Military:
Military: Autonomous triage and toxidrome-directed treatment in chemically contaminated, battlefield environments, protects medics from entry and prolongs casualty survival until human care is possible.

Civilian:
Similarly, autonomous systems capable of assessing and delivering life sustaining treatments during disaster responses, industrial chemical accidents, hazmat operations, and chemical terror attacks in which fire/EMS response will be delayed provides additional safety for responders and a survival advantage for casualties during public-health emergencies [2]. The autonomous system will perform initial triage and treatment in the hot zone so that responders either avoid entry entirely or gain time to don protective equipment.

Schedule of Milestones and Deliverables

Base (24 mo)

• Month 1:
  1. Kickoff Meeting and detailed review of project plan;
  2. Confirmation of receipt for GFE generic simulated casualty data.
• Month 2:
  1. Report on integrated system architecture, autonomy/human-machine teaming approach, and updated performance goals derived from Feasibility Documentation;
  2. Initial assessment and plan for augmenting previously collected GFE data with selected toxidrome findings.
• Month 6: Report on sensor/detection subsystem integration and initial in-silico or bench detection results for the first selected toxidrome with measured sensitivities.
• Month 12: Report and video demonstration of first toxidrome characterization and treatment action on a simulated casualty (manikin).
• Month 15: Report on sensor/detection subsystem integration and initial in-silico or bench detection results for the second selected toxidrome with measured sensitivities.
• Month 18: Report and video demonstration of second toxidrome characterization and treatment action on a simulated casualty (manikin).
• Month 24:
  1. Final base-effort report and prototype video demonstration of assessment and treatment of 5 casualties in a relevant environment against defined success criteria;
  2. Commercialization/transition plan.

Deliverables:

1. Augmented toxidrome #1 dataset
2. Video demonstration of toxidrome assessment #1 (computer simulation)
3. Video demonstration of toxidrome assessment #1 (manikin assessment) and treatment (manikin)
4. Augmented toxidrome #2 dataset
5. Video demonstration of toxidrome assessment #2 (computer simulation)
6. Video demonstration of toxidrome assessment #2 (manikin assessment) and treatment (manikin)
7. Video(s) of final demonstration: assessment and treatment of 5 manikin casualties

Option (6 mo):

• Option (Months 25–30):
  1. Maturation for transition — demonstration of treatment only interventions on a live actor under human-subject research protocol in a controlled environment.
  2. FDA Interact Meeting completed.

Deliverables:

1. Safety Assessment/Report and video demonstration of autonomous assessment and treatment of at least one toxidrome on a live actor.
2. Regulatory approval plan.

References

1. Dembek ZF, editor. Medical aspects of biological warfare. Government Printing Office; 2008 https://medcoe.army.mil/borden-tb-med-aspects-chem-warfare.
2. Ramesh AC, Kumar S. Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents. PHARMACY AND BIOALLIED SCIENCES. https://www.researchgate.net/profile/Praveen-Kumar-Amar/publication/51559634_Ensuring_safe_water_in_post-chemical_biological_radiological_and_nuclear_emergencies/links/5d86c004299bf1996f8f0930/Ensuring-safe-water-in-post-chemical-biological-radiological-and-nuclear-emergencies.pdf#page=91
3. https://www.darpa.mil/sites/default/files/attachment/2026-05/dtc-challenge-program-summary.pdf
4. Keating B, Eide KL, Vaag JR, Lund-Kordahl I. Tactical Triage: Adapting Care and Decision-Making for High-Threat Environments. https://d1wqtxts1xzle7.cloudfront.net/124804666/1214491-libre.pdf?1759174845=&response-content-disposition=inline%3B+filename%3DTactical_Triage_Adapting_Care_and_Decisi.pdf&Expires=1785165685&Signature=QFWWSKX-r6fEEHHLrdArptS2nKVaS13Ai8yld5vYIo33BbW3K1V20pEDu6EEIKXS~bACTkYzYhRS5V1g6VI511ZhsiwffzWFW0yUdv9Dw3~GIFgrbjpYaaUToRWmSGopAuYtqoHhybbj3n7-YVZISfjMVHOBB37fzShwVf46GcQWk9BsNvg2RwXIv6ieMYUcsxphRidYdtZRHOVXaC0PrEd4-8OJhSSP~W2v1duk9euv4KNUkeOgxF3zMXJZQFnHdBYjHQrYXzxxbBUL3c5vxPP8OD2jzMMc-BqHqqm-bONrVr0YaH0b1EajUkugKDbp6yfNuTAIFuXv2wnbdzDTnQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
5. U.S. Department of the Air Force. (2021). Air force tactics, techniques, and procedures 3-42.32: Installation medical all hazards response (IMAHR). Secretary of the Air Force. https://static.e-publishing.af.mil/production/1/af_sg/publication/afttp3-42.32/afttp3-42.32.pdf
6. Marrs TC. Toxicology of organophosphate nerve agents. Chemical warfare agents: toxicology and treatment. 2007 Mar 23:191-221. https://onlinelibrary.wiley.com/doi/book/10.1002/9780470060032#page=196

Keywords

medical triage; mass casualty incidents; autonomous systems; robotics; medical countermeasures; chemical warfare injuries

TPOC-1-PoC

DARPA BAA Help Desk

Email

SBIR_BAA@darpa.mil

Ready to apply?

For additional information and to submit your full proposal package, visit the DSIP Portal.