When a Marine is wounded far from a hospital, the difference between life and death often comes down to what a corpsman can do in the first few minutes — with whatever fits in a pack. The Marine Corps is now fast-tracking two new medical devices designed to stretch that survival window, drawing directly on lessons from combat deployments in the Middle East and across the Pacific.
Following accelerated pushes for battlefield medical technology, Marine Corps officials confirmed this month that two pieces of equipment — a portable AI-assisted ultrasound called the Kosmos and a compact blood refrigerator known as the Expeditionary Medical Refrigeration Unit, or EMRU — are being fielded more broadly and more quickly than originally planned. The push comes after direct feedback from medical personnel supporting operations tied to the Iran conflict and from units forward-based in the Pacific.
Rethinking the “Golden Hour”
For decades, military medicine has centered on the “Golden Hour” — the critical 60 minutes after a wound during which rapid evacuation and triage care dramatically improve survival odds. But in modern distributed combat environments, where medevac may not be available quickly, that framework is being rethought. Officials now say the goal is to equip frontline corpsmen with tools that can sustain a patient’s life far longer at the point of injury, reducing dependence on fast evacuation to rear-area hospitals.
Brig. Gen. Tamara Campbell, commander of Marine Corps Systems Command, framed the shift plainly:
“I think that we need to understand that we will be in a contested environment. 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.”
The concern is real. Managing battlefield injuries in remote or contested environments means corpsmen cannot always count on quick transfers to higher-level care. The two new devices are designed to close that gap.
A Blood Bank That Fits in the Field
The EMRU weighs 62 pounds — less than half the 140-pound refrigeration unit it replaces. It runs on rechargeable batteries, requires no heavy generator, and is built to maintain what military planners call the “cold chain” — stable, refrigerated storage of blood supplies in field environments. It can also warm blood that has frozen in Arctic conditions, preventing further harm to a patient receiving cold transfusions.
Lt. Cmdr. Kyleigh Hupfl, the Marine Corps’ clinical lead for expeditionary medical systems, said units deployed to the Middle East reported strong results with the device.
“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.”
Hupfl explained the broader logistical goal driving the push:
“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. 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.”
What began as a limited rollout is now on track for full operational capability across the Marine Corps by the second quarter of 2027, with forward-deployed units receiving priority. Hupfl was direct about the intent:
“We want to get it as far out as we possibly can.”
AI-Assisted Ultrasound for the Front Lines
The second device, the Kosmos portable ultrasound, is a significant step toward bringing diagnostic capability to the earliest stage of battlefield care. Traditionally, ultrasound exams have been performed only by Role 2 units — advanced mobile trauma centers staffed by physicians. The Kosmos is being pushed to Role 1 units: the small field aid stations and individual corpsmen who are often the first hands on a wounded service member.
What makes that possible is artificial intelligence. The device guides a corpsman through an exam and interprets what it sees on screen, helping someone without extensive clinical training recognize internal injuries they otherwise might miss. Hupfl described the challenge the AI solves:
“Using the ultrasound probe is not the thing that’s the hard part, right? 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.'”
Demand from the field has accelerated the timeline.
“We are not waiting, because we’ve heard that … the units want it now,”
Hupfl said.
Feedback Driving Decisions
The decisions behind both fielding initiatives trace back to an unusually direct line of communication between program managers and the personnel actually using the equipment. Col. Paul Gillikin, the Corps’ program manager for combat support systems, described going well below the typical chain of command to gather information.
“I’m talking with maybe lieutenants running surgical centers; that’s the level of detail we’re getting to. 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.”
Hupfl summed up what the equipment push is ultimately meant to achieve:
“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.”
