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- accident & emergency medicine
- blood bank & transfusion medicine
- health policy
- trauma management
- radiology & imaging
‘The best way to predict the future is to create it’—Abraham Lincoln
Ten years from now in 2032, evading an overloaded air-defence system, an enemy ‘smart’ drone munition, down to its last spin, self-detonates over a British position. Preformed carbon-fibre fragments energise into a 20 m radius kill cloud and a 40 m injury circle. A soldier is caught and injured. The sensors on her issued smartwatch1 immediately detect an increase in RR, a decrease in BP, altered tissue perfusion, a rise in pulse, lactate and cortisol—these last two being substances produced by stressed cells. The watch slaves to the personal communicator and geo-locator beacon on her webbing. A drone that had been delivering fresh whole blood to other forward combat units is diverted automatically and unfolds its lightweight laminated protective shield over her. Role 1 trauma care is now mostly machine led. All combat personnel are however trained to deliver advanced haemorrhage control interventions before drone retrieval.
The drone warms the microenvironment under the shield. 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. This micro-chip also carries the casualties blood-group and pharmacogenomic data. Using battlefield avoidance technology previously found on cruise missiles, it silently lifts, accelerates to its cruising speed of 300 knots and departs.
Tranexamic acid is auto-injected into her thigh to keep her wounds clotted.5 Assessing that there is not enough oxygen in her bloodstream, an oxygen generator begins to chemically generate and safely deliver 100% oxygen to a robotically placed mask …
Contributors PP planned and collated the editorial. HP, AH, MB, AJ and TK contributed to the ideas, writing and copy-editing. PP acts as guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.