Fascination Robotics Robot Treats Injured in Flight

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In our "Fascination Robotics" section, we present extraordinary robots to you once a month. Today: how a medical robotic system can provide telemedical care for injured individuals during an evacuation flight.

In a tension pneumothorax, air accumulates between the pleura and the lung—for example, after a car accident or a gunshot wound. This air cannot escape and increasingly builds up. This creates pressure in the chest, compressing the lung and eventually also affecting the heart and the large blood vessels. The pulse rises, blood pressure drops, and eventually the circulatory system collapses. "This tension pneumothorax is life-threatening," says Carolin Müller, a researcher at the Clinic and Polyclinic for Trauma Surgery at TUM Klinikum. If left untreated, those affected die within minutes. "It is often overlooked but can be easily treated by inserting a decompression needle into the chest to allow the trapped air to escape."

Robot Takes Over the Initial Care of the Injured

In inaccessible areas, this task can in the future be performed by a robot for which researchers have developed an attachment for its arm. This "end effector" combines a decompression needle, that is, a "needle-catheter system" similar to those used for venous access, with an ultrasound device. Only two positions, the "Monaldi" and "Bülau" points in the second and fifth intercostal spaces, are suitable for needle insertion. These points can be clearly identified using ultrasound. Additionally, the system can diagnose whether a pneumothorax is actually present.

With the help of the new mechanism developed by Müller together with researchers from the Chair of Microtechnology and Medical Device Technology (MiMed) at TUM, the needle and the surrounding catheter penetrate the skin into the chest cavity. While the needle is withdrawn, the catheter remains in the body, allowing the air to escape.

This gains crucial time to treat individuals with a tension pneumothorax, for example, after a chest injury resulting from a traffic accident or a gunshot wound.

Prof. Peter Biberthaler, Director of the Clinic and Polyclinic for Trauma Surgery at the TUM Hospital

Flight Capsule And Telemedical Applications Considered Together

These findings are part of the research project I-Medcap, which the European Defense Fund has been funding with a total of 27 million dollars for three years since its start on December 1, 2023. The focus is on the "development of intelligent military capabilities for monitoring, medical care, and evacuation of infectious, injured, and contaminated individuals." Led by the TUM Chair of Flight System Dynamics, 24 organizations from nine countries are involved in the research, including the German Federal Ministry of Defense, Bundeswehr institutes, and the start-up Avilus, which develops drones for medical evacuations and was co-founded by five doctoral students from TUM.

The goal is, among other things, to use the Avilus aircraft "Grille," already in testing, to evacuate severely injured patients remotely and as quickly as possible from danger zones and crisis areas. The robotic arms to be installed in the drone in the future will enable treatment during the flight. A doctor can join remotely. The emergency medical decisions made remotely can be implemented by the robotic arm through intervention modules, thus saving lives.

Further Robotic Modules in Development

The MiMed research group Rescue-Robotics, led by Christoph Parhofer, is currently developing additional robotic modules. These include modules that can independently administer medications via a so-called osseous access through the bone, stop severe bleeding in the arms and legs by applying a tourniquet system, or, in the event of a military emergency involving chemical weapons, administer atropine, for example. "Our robotic modules are capable of performing some of the tasks required immediately after an accident," says MiMed chairholder Prof. Tim Lüth.

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