Autonomous Life Support, Diagnosis, and Intervention

Remotely controlled interventions require high bandwidth and short communication delays. Guaranteeing a reliable communication link in the battlefield is not always possible, and coordinating with remote medical personnel can be very challenging. Furthermore, some monitoring functions and therapies are better suited to closed-loop computer control than to human supervision.

During the NEEMO 9 mission, a surgical robotic system was set up in Key Largo, FL, and controlled from 1,500 miles away in Ontario, Canada to perform procedures such as vascular suturing on a plastic medical model.

For example, when injured soldiers are airlifted over the ocean while hooked up to ventilators and vital sign monitors, they rely on the limited resources of the medical personnel onboard the aircraft. A closed-loop life support system could monitor the patient second-by-second and perform small adjustments based on the information collected. This would allow medical personnel to allocate their attention to the patients that have the most serious problems. Closed-loop ventilation has been demonstrated to be more precise and require less oxygen than ventilation controlled by medical staff. Similar studies have been performed for fluid administration and anesthetics. Systems integrating autonomous life support will make it into the market within the next few years.

Diagnosis capabilities in the field are another important consideration for researchers. As imaging is advancing into smaller CT and ultrasound machines, the limiting factor for per forming a clinical diagnosis becomes getting a radiologist to analyze the images. Given the size of the data sets and bandwidth limitations, developing a “front-line” computer that can provide a preliminary diagnosis is an attractive option that is actively being pursued in research.

Using an ultrasound probe and aspirating needle, the M7 robot performed an intravenous insertion on a simulated blood vessel as part of the NEEMO 12 mission.

Finally, one of the most important medical resources for injured soldiers is the medic or buddy who makes life-or-death decisions at the point of injury with very limited information and resources. Life-saving procedures such as securing an airway, starting an IV, or placing a chest tube require a significant level of training and skill. It only makes sense that technology could assist these individuals in performing life-saving procedures or making assessments on the conditions of patients. As such, researchers are developing devices that can perform these procedures autonomously; for instance, the device would contain sensors that help guide the medic in locating a particular vessel during a life-saving intervention.

The concept of remotely controlled medical care is moving toward one of human-supervised autonomous operations, in which robotic devices are capable of interpreting and acting on sensor data to provide better feedback to the surgeon. Autonomous or supervised procedures may make it into the field sooner than remotely controlled technologies due to bandwidth limitations and the potential to provide better performance than humanly possible. Even then, humans, not robots, will be in charge.

This article was written by Pablo Garcia, Principal Engineer and Head of Medical Robotics; and Tom Low, Director of Medical Systems and Robotics for SRI International in Menlo Park, CA. Contact Pablo at This email address is being protected from spambots. You need JavaScript enabled to view it., or visit http://info.hotims.com/28053-162.