When medics with the 173rd Airborne Brigade called for blood supplies to treat combat wounds in a major exercise last month, the flying machines slashed life-saving minutes in transport time and used fewer troops to do it.
“The difference is someone dying and someone not, because four minutes is substantially faster than 20 or 30,” said 1st Sgt. Cyril Clayton, a senior medic with the 173rd Brigade. “As far as risk to the force goes, we’ve cut it from probably five to two.”
The Army has long relied on the bravery of helicopter pilots or fast-moving ground vehicles to get medical resources into the hands of medics treating wounded soldiers on the frontlines, including blood supplies. In a recent exercise held in Lithuania, that meant moving blood supplies three to four kilometers, which could take five soldiers 20 to 30 minutes in a field ambulance.
But for Swift Response 2025, a mobility and airborne exercise with Finland, Latvia, Lithuania, Norway and Sweden across the Baltic and Arctic regions, the 173rd used drones to move blood.
The use of drones is part of the Army’s effort to move blood supplies faster and closer to soldiers injured in combat, as the U.S. prepares for a large-scale conflict with more casualties but fewer chances for safe air evacuations to hospitals outside of combat. U.S. military researchers have estimated that 15–20% of traumatic deaths are potentially preventable, and 66–80% of deaths are caused by blood loss.
In addition to cutting down on risk to the service’s already-limited medical personnel, using drones to carry blood supplies was also a stepping stone towards a future where the drones could transport injured patients from the front lines to field hospitals for life-saving care, said Maj. David Hourani, a surgeon for the 173rd Airborne Brigade.
“The force of drone movement on human tissues is about as good as we can do prior to actual humans,” Hourani said.
Keeping blood ‘viable’
Army medics use a range of blood supplies, including whole blood, red cells, platelets, and plasma. For each. Personnel have to keep it on ice until ready to use. During Saber Junction in September, line medics parachuted with blood supplies — a technique that they quickly learned was not the best option because of the need to maintain the temperature with ice.
“There’s definitely a limited shelf life on how long we can keep units,” Clayton said. “The requirements for ice are heavy and anytime you’re going to jump something under canopy, that’s a concern so they need rapid ability to either recool or have access to ice, which are both tall orders.”
Additionally, the violent G-forces and impacts of parachuting can cause damage to the blood cells’ outer membrane.
“Main concern for us is — is it safe to deliver human tissue at those speeds, at the force being applied to that tissue? Is it still gonna be viable when it gets to the patient that needs it?” Clayton said. “Each of those cells in that bag is potentially life-saving. Any force outside of normal parameters could potentially damage those cells … and then they’re no longer viable for resuscitation.”
The exercise began with blood support detachment personnel bringing whole blood supplies to medical laboratory specialists at a main command post. There, teams loaded up around 18 units of blood — enough for roughly five casualties, depending on injuries — onto the drones in a Collins Box, a cardboard shipping container with Styrofoam insulation.
The technicians loaded and then flew the drone to the field hospital, said Capt. Jessica Knoll, commander of the brigade’s support medical company.
Once the blood was delivered, the operators flew the drone back to the command post for another resupply. They were able to make two long-distance movements of three to four kilometers into battle and three smaller-scale rehearsals.
“In an actual combat theater, it could be 20-30 [kilometers],” Clayton said. “I don’t think there would be any issues with temperature for that amount of time. The biggest thing is going to be the navigation piece. They’re just covering that much distance.”
From the exercise, the medical team realized two challenges: resources and airspace. In order to keep drones powered up for hours or flying, they needed a tent to house the equipment, a generator to charge batteries and a viewing station for the operators.
In a future large-scale conflict, militaries will need to “deconflict” the airspace above the battlefield, accounting for thousands of drones and regular aircraft like helicopters taking flight above ground forces.
“If a helicopter is coming in low, the drones are grounded, whereas if the helicopter is maintaining airspace above 500 feet, drones are good to fly at 100-200 feet,” Knoll said. “It really comes down to the drone operator being aware of what’s going on and then being able to quickly react to any incursions into our reserve airspace to ensure that there’s no in-air collisions.”
Drones in medical companies
As the Army expands the number of drones within its formations, the service is planning to have drone experts down to the platoon level in infantry and artillery units. But for medical companies, the use cases will look and feel different. In combat, medics are considered “protected” under the rules of war set by the Geneva Convention, which means their drones cannot be used for offensive operations.
“For medical, we have to adhere to the Geneva Convention, all of ours are resupply, in which case, they are much bigger because they have to be able to handle a payload,” Knoll said.
“Our concerns are making sure that we’re using the drones defensively and not offensively, and ultimately to render aid to service members in need and not for defense.”
The 173rd Medical Company tested Class II-designated drones, which weigh between 21 and 55 pounds, and fly as high as 3,500 feet. During the exercise, they used the TRV 150 cargo drone, which is roughly 8.5 feet long and 6 feet wide, weighs around 125 pounds, and can carry 150 pounds of cargo. They also used the FlyingBasket drone, which is around 5 feet wide, weighs 150 pounds and can carry up to 220 pounds.
Knoll said that the two drone teams weren’t confident flying more than 30 minutes at a time because of the drone’s battery life. They also kept the drones within five kilometers for communication.
“We need more training. We need more time with the pilots flying the drones,” Knoll said. “Then we need the platform to be available for us to do that training and we definitely want to continue developing this and really push the limits of what these drones are capable of so that we can push the limits of what we can do medically.”
The 173rd company plans to use drones for blood resupply at exercises next fall and spring. In the meantime, their drone pilots will continue running simulations with and without payloads.
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