A wounded soldier waits for help. A rescue team knows where to find him. But the same drones that struck his position now threaten anyone who tries to reach him. Minutes become hours. Hours become days. That predicament sits at the center of Dr. Mark M. Mims’s presentation, “When the Drone Gets Through: Emerging Injury Patterns in Modern Warfare,” at the recent Counter-UAS Accelerator Working Group (CUAS-AWG) in Grand Forks, North Dakota. Drawing on his work with Ukrainian surgeons, Mims described a battlefield where drones do more than inflict devastating wounds. They also obstruct the medical response that could keep those wounds from becoming fatal. His message to the counter-drone community starts with its most important mission: protecting people.
Drone Attacks Are Changing Battlefield Trauma
Mims, a facial plastic and reconstructive surgeon at the University of Oklahoma Health Sciences Center, founder of Operation Ukraine at OU Health, and CEO of Vantorix Systems, approaches drone warfare through the lens of its human consequences. His work with Ukrainian surgeons has connected advanced reconstruction with the urgent challenges of frontline trauma care.
In his presentation, he contrasted the injury patterns familiar from Iraq and Afghanistan with those emerging in Ukraine. Small-arms wounds and blasts from improvised explosive devices below a casualty have given way to drone attacks that can approach from above and strike close to the body. Mims described a growing burden of injuries to the upper chest, neck, head and arms.
The direction of attack matters. An FPV drone operator can steer toward the junction between the head and shoulder to exploit a vulnerable area around protective equipment. A chest plate may protect the torso without shielding the adjacent neck and face.
The resulting trauma combines several mechanisms. Blast pressure can damage the ears, lungs and other air-containing organs. Fragments penetrate tissue. Heat causes burns. Mims also described how burning drone-battery fragments can prolong contact with skin and clothing, adding deeper thermal injury to blast and fragmentation wounds.
He linked these devastating injuries and delayed evacuation to a worsening ratio of wounded personnel to deaths: approximately 10 to 1 in Iraq and Afghanistan, compared with 3 to 1 in Ukraine, a ratio he compared to World War II.*
For those that actually survive, the consequences extend beyond the first lifesaving operation. Damaged hearing, extensive burns and complex head and neck wounds create needs for reconstruction and rehabilitation. Stopping the initial attack therefore protects more than a soldier’s immediate survival. It can prevent injuries that reshape the rest of that person’s life. “We want to protect buildings and hardware because we need that for infrastructure, for daily life, for military operations,” Mims said. “But ultimately counter-UAS is to protect people.”
Persistent Drone Threats Disrupt the Golden Hour
The drone’s effect on rescue may prove as consequential as its explosive payload. Mims contrasted battlefield evacuation challenges with the rapid helicopter-based response familiar from Iraq and Afghanistan. That earlier model sought to bring casualties to lifesaving care within the “Golden Hour.” Persistent drone surveillance and attack now make movement toward a wounded soldier dangerous, sometimes delaying evacuation for days.
“Somebody gets injured,” he said. “If they’re lucky, they have a battle buddy nearby.” That companion may have to sustain a severely injured person while waiting for conditions that allow rescuers to approach. Mims described how young soldiers today have to carry responsibilities that, in a hospital, would fall to teams of doctors and nurses working around the clock.
The danger extends to those trying to save lives. Mims described an enemy that targets medical personnel and evacuation teams rather than respecting their humanitarian role. He put the average time a medic remains on the front lines in the drone-threatened “kill zone” before being killed or wounded at approximately seven days. That figure underscores the human cost of attacks on caregivers and the urgent need to extend counter-drone protection to those delivering lifesaving care.*
Counter-UAS protection thus has a second lifesaving role after an attack. It must help protect the casualty, the rescuers and the route to care. A system that prevents one drone strike but leaves an evacuation team exposed has addressed only part of the problem.
Medical Robots Must Do More Than Move Casualties
Unmanned ground vehicles (UGVs) offer one response to the current battlefield dilemma. Mims described how teams send robotic vehicles forward, load casualties and transport them back toward collection points without placing a driver or accompanying medic on the vehicle.
But removing the medic creates another gap. “The problem is there’s nobody on that UGV and there’s no system to monitor that casualty as they’re going back,” he explained.
A robot can move a patient while leaving their worsening conditions unseen. Mims illustrated the problem with a casualty 20 kilometers inside a threatened area and a vehicle traveling at five kilometers per hour. The journey would require four hours, potentially without monitoring or treatment.
That distinction separates robotic transport from robotic medical evacuation. Mobility gets the casualty moving. Medical capability must help keep the casualty alive. “We need systems to figure out how that patient is doing and maybe even systems to treat that patient en route,” Mims urged.
His own company, Vantorix Systems, focuses on this very issue. When a medic cannot safely reach a casualty, can technology bring some of the medic’s capabilities to that person instead? In environments where access and evacuation remain delayed or impossible, the immediate challenge is not simply building a robot. It is deciding which lifesaving functions can reach a patient through remote support or autonomous systems, and which still require skilled personnel at the bedside. For innovators, his presentation pointed toward a development priority: medical autonomy to connect transport with patient assessment and, where feasible, treatment.
Remote Medicine Must Extend Expertise Into Dangerous Environments
Mims’ also discussed how technology can extend medical expertise without physically moving every specialist to the patient. For example, smart surgical glasses can allow military surgeons to livestream their view of an operation and receive support from specialists like the ones at the University of Oklahoma. That connection can bring experienced clinicians into the decision-making process as local surgeons perform the procedure.
Training must advance alongside those technologies. Mims described his own work to strengthen trauma skills among frontline surgeons, including vascular trauma training, with the aim of extending practical knowledge toward those providers. Robotics cannot eliminate the need for capable people, but it must support them where distance and danger limit their reach.
Counter-Drone Protection Must Include Medical Evacuation
Mims urged the counter-UAS community to treat medical care as another layer of defense. The first objective remains preventing the initial injury. After a strike, priorities expand to preventing follow-on attacks, protecting rescuers and shielding casualty evacuation. Mims specifically raised the danger of “pop-up” drones waiting near casualties or along routes where medical personnel may move.
Protection need not eliminate every effect of an explosion to matter. He described standoff distances around evacuation vehicles as an effort to create physical separation between an attacking drone and the people inside. The goal, he emphasized, is survival rather than a guarantee that no blast will occur.
The larger lesson concerns the connection between protection and care. Counter-drone systems can reduce exposure. Medical robotics can reduce the need to send additional people into danger. Remote expertise can support clinicians who lack immediate specialist help. Together, those capabilities address different stages of the same casualty’s struggle to survive.
Battlefield Survival Requires Counter-UAS and Medical Innovation
Mims closed by calling for collaboration across military organizations, industry, government and academia. No single institution controls every part of the problem, from detecting an approaching drone to reconstructing a survivor’s injuries. That collaboration must connect technologies that often develop in separate communities. Counter-UAS teams work to keep the drone from reaching its target. Medical teams work to preserve life when it does. Robotics and remote care can help bridge the dangerous interval between injury and treatment.
The human stakes include morale. Soldiers need confidence that someone will come for them if they fall. Mims stressed that the prospect of rescue matters both medically and psychologically.
His parting shot to the counter-drone community was to include this important medical layer as part of any layered defense equation. When the drone gets through, protection has not finished. It must follow the wounded person all the way to care.
*These figures were presented as the speaker’s assessment rather than an independently verified statistics.
Photo credits: Drew Swenson / Livewire, courtesy of S4B Defense Corp.