For the Marine Corps, one lesson to come out of Operation Epic Fury is a clear mandate to move faster on technology that might make battlefield injuries less lethal. And the service is doing just that, ramping up acquisition processes for two new devices, a portable smart ultrasound and a blood refrigerator, that promise to keep troops alive for longer at triage points.
In a call with reporters this month, Col. Paul Gillikin, the Corps’ program manager for combat support systems, said he has been closely tracking feedback from Navy surgical teams and Marine Corps medical units deployed in support of the Iran fight and forward-based in the Pacific and elsewhere around the world.
“I’m talking with maybe lieutenants running surgical centers; that’s the level of detail we’re getting to,” he said. “I’m talking to that lieutenant, lieutenant colonel over SIPR and NIPR [military networks] to find out exactly what they’re experiencing and how I can make their life better and how I can make operations and support better for them … it’s an all-engine stop affair.”
And as a result of that direct feedback, Lt. Cmdr. Kyleigh Hupfl said, the Marine Corps’ clinical lead for expeditionary medical systems, the service is accelerating fielding of the Expeditionary Medical Refrigeration Unit, or EMRU, a compact 62-pound cooler that she said will be critical to establishing a field-ready blood bank operation for distributed units that may need to sustain themselves for longer periods of time before there’s a chance at medevac to a better-equipped hospital facility.
It replaces a larger 140-pound unit that required far more manpower to transport and could sustain about 24 hours of refrigeration in ideal conditions, officials said. The EMRU, with rechargeable batteries, is designed for long-term sustainment of what officials call the “cold chain” for blood supplies in field environments.
The officials who spoke with reporters said the concept of the Golden Hour, the first 60 minutes after wound or injury, where triage care and limiting blood loss is critical for survival odds, is taking a backseat to a longer-term concept of care that ensures corpsmen can continue to limit hemorrhage and keep vitals strong with tools that might previously have been reserved for more established medical centers in the rear.
“What we’re trying to get after with the equipment is identifying those things that are saving that life in that first hour and ensuring that they can be distributed, they can be applied, they can be carried on the back of a corpsman, and they’re supported logistically,” Hupfl said.
“We need to be able to bring cold chain distribution forward without relying on heavy generators, and we need to be able to do that in a sustainable way,” she continued. “We need to be able to warm that blood so that we don’t get that patient in a worse off situation, and we need to be able to see … whether they have continued bleeding, so that the commander can make a risk decision on putting an evacuation asset at risk to get that patient out.”
With the EMRU, which can keep blood bags at a stable cold temperature, but also warm them if they freeze in Arctic conditions, units sent to the Middle East have received positive feedback from medical providers there, Hupfl said.
“We were told that the gear was instrumental to their ability to maintain a revolving lead bank to ensure that they had what they needed to be ready to care for injured service members,” she said.
An early rollout has now turned into a plan to push the refrigerator into full operational capability status across the Marine Corps, reaching full fielding by the second quarter of 2027, she said, with point-of-need units receiving priority treatment.
“We want to get it as far out as we possibly can,” she said.
Likewise, she said, a portable ultrasound device, the Kosmos, which allows corpsmen to conduct an AI-assisted fast exam in the field, has been greenlit for expanded fielding. While ultrasounds have traditionally been performed only by Role 2 medical units, or advanced mobile trauma units staffed by doctors, these devices are set to be pushed to Role 1 units, the smaller immediate-aid field units and embedded corpsmen who often provide the first care to patients.
“We are not waiting, because we’ve heard that … the units want it now,” Hupfl said.
Ease of use and the AI support, she said, enable the more basically trained corpsmen to operate the ultrasound with confidence.
“Using the ultrasound probe is not the thing that’s the hard part, right?” she said. “What’s hard is you’re looking at an image and you don’t know what it means. With the AI assistants, somebody who doesn’t have many years of clinical experience doing ultrasound can look at that screen and it helps them to identify, ‘Hey, this is what I’m looking at, and there might there’s an injury here.’”
Brig. Gen. Tamara Campbell, commander of Marine Corps Systems Command, suggested that these fielding initiatives are part of a greater effort that will move the Marine Corps further away from a three-tiered medical care system in which Role 3 — the military hospital — has often been the urgent and accessible destination.
“I think that we need to understand that we will be in a contested environment,” she said. “And whatever we need to apply care to sustain that life until we can get them to a different point of care [will need to be] at that point of injury.”
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