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Editorial
UK Field Medical Care 2032: one Military Vision
  1. Paul Parker1,2,
  2. H Pynn3,
  3. A G Haldane1,
  4. M Ballard4,
  5. T C König1,5 and
  6. A M Johnston6
  1. 1 16 Medical Regiment, Merville Barracks, Colchester, UK
  2. 2 Senior Lecturer in Special Operations Medicine, University College, Cork, Eire
  3. 3 Bristol Royal Infirmary, Emergency Department, Bristol, UK
  4. 4 Radiology Department, RCDM Birmingham, Birmingham, UK
  5. 5 Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  6. 6 Department of Anaesthesia and Intensive Care Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Paul Parker, Trauma & Orthopaedics, Queen Elizabeth Hospital, Birmingham, UK; parker_paul{at}hotmail.com

http://dx.doi.org/10.1136/bmjmilitary-2021-002056

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    ‘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 …

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    Footnotes

    • Twitter @armycritcare

    • 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.