mends a therapy. At the highest level, it decides and acts
on the casualty without human input, something that
the U.S. Food and Drug Administration (FDA) currently does not allow.
“We are working with the other services and with
the FDA,” he said. “We want to get closed-loop medical therapeutic approved by the FDA” much quicker.
ACCS also provides the patient’s information remotely to a receiving facility and is being developed with
communications capability to talk with the patient.
“At some point, we will be interacting with the
SimMan, so if he makes some kind of negative change,
his program says he is bleeding hard or whatever, the
ACCS can detect that,” he said.
Cardiac output is how much blood the heart pumps
in a minute. Bentley said a device that measures and
monitors that “currently doesn’t exist in the field at all.”
That vital sign is significant, especially on the
battlefield where many wounds cause massive blood
loss. Without sufficient resuscitation or measures like
tourniquets or blood-clotting bandages, hemorrhaging
patients face lower rates of survival.
“Almost all of the people who could have been saved
on the battlefield, in retrospect looking at the casualties
from Afghanistan and Iraq, died of bleeding to death,”
Currently, there is no snapshot picture of what is
happening to a patient throughout the transport, said
Christopher Santee, a retired master chief and hospital
corpsman and support contractor with ONR’s Warfighter
Performance Science and Technology Department. With
the ACCS, “now we can have a bigger plot to show this
is what the guy did during this whole time.”
Officials envision the data collection and patient mon-
itoring will serve as a “decision assist” to help corpsmen,
physicians and other medical providers stabilize and
Corpsmen and trauma providers can take different
measures to stabilize casualties and control blood pressure, which in turn can lessen hemorrhaging, but they
also must maintain other vital signs, some of which
might not be as obvious. Medical devices like ACCS can
assist them by providing various data such as how much
oxygen or red blood cells are in the blood and whether a
patient has received too much fluid and risks drowning
from the inside out, Bentley said.
The ACCS can share that data via the Medical COP, or
common operating picture, accessible to providers and
commanders on the ground and at the sea base, helping
manage patients and steer them to the proper level of
care. A tablet can coordinate patients with several ACCS
devices into something like a triage or nurses’ station
and help manage transport, which “frees up people to
do more interactive, human-oriented care,” Bentley said.
“It will never replace” the person, he added. “The
machine will never be the same as the educated, capable
physician or IDC [independent duty corpsman]. Yet,
at some point, it may have some more knowledge than
buddy aid, for instance.”
For the summer experiment, ONR did not have air-
worthiness certification approval to use the ACCS active-
ly on the MV- 22, so real-time vital signs and electronic
data from the SimMan patient could not be transmitted
and shared. ONR is working with Naval Air Systems
Command at Patuxent River, Md., to get the certification
for testing during next summer’s Bold Alligator exercise,
Bentley said. Meanwhile, ACCS might be used for some
testing and development with an MV- 22 Osprey mockup
fuselage at Naval Medical Center San Diego, he said.
ONR had planned to test the ACCS aboard a ship
during RIMPAC but the ship was not available. For
Bold Alligator 2017, “we want to do the same form and
fit and function or flow aboard ships,” Bentley said.
“We want to be able to move it on and off ships with
helicopters or MV-22s. We want to be able to move
from shore to ship, perhaps from ship to shore again
with the communications capabilities on. And if we’re
ready, we would like for SimMan to be cared for by the
ACCS, even if it’s a very scripted care.”
For Bold Alligator, ONR also wants to demonstrate
its form or fit with autonomous ground and air vehi-
cles, perhaps a quad copter.
“We want to get it to a location and then start to
understand what are the limitations on the vehicle,”
Carrying casualties via drones?
Eugene Daniels, right, a contractor with the Office of Naval
Research, explains the Autonomous Critical Care System
(ACCS) to attendees during the Modern Day Marine Expo at
Marine Corps Base, Quantico, Va., in June 2015. The ACCS
can deliver intravenous fluids, oxygen, medication and stabilize blood pressure, as well as provide real-time medical
information and tracking throughout a patient’s transport.