Proof-of-concept of an autonomous medical evacuation system integrating ground and aerial unmanned platforms with robot-assisted patient care for military and civilian CBRN emergencies

Background Modern military conflicts and large-scale civilian disasters increasingly occur in environments that are inaccessible or hazardous for conventional medical evacuation, particularly under chemical, biological, radiological and nuclear (CBRN) conditions. These scenarios expose rescue personnel to considerable risk while simultaneously delaying definitive treatment of severely injured casualties. Recent advances in autonomous systems, telemedicine and medical robotics create the opportunity to fundamentally redesign prehospital evacuation concepts. Objective This study presents the proof of concept of an integrated autonomous medical evacuation system combining unmanned ground vehicles (UGVs), unmanned aerial vehicles (UAVs), a modular patient transport box and robot-assisted medical intervention. The project was conducted within the European Defense Fund program iMEDCAP (Grant Agreement No. 101121421) to investigate the technical and medical feasibility of autonomous casualty evacuation in high-threat environments. Methods A representative CBRN mass-casualty scenario was developed to define operational requirements. Based on these requirements, existing ground and aerial autonomous platforms were adapted to transport a standardized patient capsule equipped with physiological monitoring, telemedical communication and robotic intervention capabilities. The overall rescue workflow was structured according to an autonomous emergency care loop with continuous human clinical supervision. Results The resulting system architecture demonstrates the technical feasibility of integrating autonomous transport, telemedicine and selected robot-assisted life-saving interventions into a unified evacuation concept. The modular patient box enables seamless transfer between different transport platforms while maintaining continuous monitoring and remote clinical oversight. Conclusion This work provides the first comprehensive proof of concept for an integrated autonomous medical evacuation system intended for military and civilian CBRN emergencies. Although clinical implementation will require extensive technical validation, ethical assessment and regulatory approval, the presented concept establishes a scientific framework for future autonomous casualty evacuation systems.