Automated Critical Care System
The Automated Casualty Care System (ACCS) is now in final baseline development. This has stimulated a critical upgrade to telehealth connectivity software known as the Athena Device Management Suite or ADMS. As such it is to be an evolving platform integrating currently cleared systems, new technologies and yet can integrate new innovative capabilities well into in the future. The ACCS effort is designed to incorporate complex but proven medical technologies into a “system of systems” that integrate patient physiological monitoring with interventions controlled by software algorithms to provide automatic medical care of critically injured warfighters. This includes the medically cleared WVSM®, acquiring baseline vital signs without care provider attendance as an example. The baseline ACCS system will assist the caregiver by providing casualty management guidance and decision assistance based on continuously updated measures of patient’s medical status and currently known, well-documented (e.g., TCCC and PHTLS) doctrines, and implemented casualty care protocols and strategies. The future manifestation of ACCS may be closed loop autonomous care as these technologies mature and are released to market by evolving FDA policies and test validation/verification (V&V) data. However, the baseline ACCS allows the simple transition to advanced capability through the efficient integration of precursor tenets of design.
For example, the current combat environment does not always provide or even allow for constant wireless monitoring by a dedicated care provider nor for near real time remote clinical care provider input and control. However, ACCS integrated a bidirectional, telemedicine-capability within ADMS and has already demonstrated this in early Op Eval via current military communications methods and Android smart phones. Similarly, the autonomous capability of ACCS follows the innovations of the WVSM by enabling recognition of unstable casualty conditions derived from vital signs and corpsman inputs and trending of the patients’ vitals allowing for earlier awareness, intervention and increased urgency of life saving interventions, which has been shown to improve patient outcomes resulting in fewer hospital days, reduced cost of treatment, and quicker return to duty. This capability is currently being used to prioritize not only urgency of care alerts but data review and presentation priorities and then when FDA technologies mature provide closed loop control feedback and autonomous intervention. Also, as advanced traumatic brain injury (TBI) treatment technologies such as therapeutic hypothermia (THT) come through FDA clearance, the basic platform of ACCS can and will adopt those technologies inside a modular framework that is now existing with the integrated OV fluids. Finally, the baseline system and software control carries state of the art internally controlled IV/IO fluids (rate, volume, type and temperature) as colloids and crystalloids but allows for a modular upgrade to blood and blood products essentially as a “plug and play” as they evolve into more common use and clinical practice.