Could AI help ER doctors and medics make better decisions?

Could AI Help ER Doctors and Medics Make Better Decisions?
Summary of "Click Here" Podcast Episode
Recorded Future News | Release Date: February 18, 2025

Introduction

In the February 18, 2025 episode of "Click Here" by Recorded Future News, host Dena Temple West explores the intriguing intersection of emergency medicine and artificial intelligence (AI). The episode, titled "Could AI Help ER Doctors and Medics Make Better Decisions?", delves into the real-life experiences of Dr. Kevin Menes, an ER physician who faced an unprecedented mass casualty event during the Las Vegas shooting in 2017. This narrative sets the stage for a broader discussion on how AI could augment decision-making in high-pressure medical and military scenarios.

Dr. Kevin Menes: From Inspiration to Reality

Early Inspiration and Career Path

Dr. Kevin Menes' journey into emergency medicine was inspired by a childhood television show. As recounted by Dena Temple West ([00:02]), Dr. Menes admired the calm demeanor of ER doctors portrayed on the show Emergency. This admiration motivated him to pursue a career in emergency medicine, leading him to train in one of Detroit’s most demanding hospitals before becoming the lead ER physician at Sunrise Hospital in Las Vegas.

The Las Vegas Shooting: A Night of Chaos

On October 1, 2017, Las Vegas was thrust into chaos when a gunman opened fire at a popular outdoor country music festival. Dr. Menes was on duty in the ER when he received urgent news of the mass shooting ([02:18]). The hospital quickly mobilized every available resource, transforming the ER into a bustling hub of life-and-death decisions. Dr. Menes describes the night as “the scariest thing you can ever handle or deal with” ([03:58]), highlighting the unprecedented scale and intensity of the event.

Navigating the Mass Casualty Event

Triage in Action

Faced with an overwhelming influx of victims, Dr. Menes and his team employed the mass casualty triage system, a protocol dating back to Napoleon’s time. This system categorizes patients based on the severity of their injuries using color codes:

Red: Critical injuries requiring immediate attention.
Yellow: Serious injuries but not immediately life-threatening.
Green: Minor injuries.
Black: Deceased individuals.

Throughout the night, Dr. Menes had to make rapid decisions, often deviating from standard protocols to manage the sheer volume of patients. He reflects on moments when he chose not to immediately black-tag deceased patients to prevent overwhelming the medical staff ([17:21]): “That's correct.”

Emotional and Physical Toll

By dawn, Dr. Menes was physically exhausted and mentally drained, grappling with the trauma of the night's events. He pondered whether he could have managed the situation better, questioning his decisions and wondering if different actions could have saved more lives ([09:51]).

From Trauma to Innovation: DARPA's Involvement

Publishing the Experience

Encouraged by a mentor, Dr. Menes documented his experiences in a journal article. This publication unexpectedly attracted the attention of Matt Turek, Deputy Office Director for DARPA’s Information Innovation Office ([10:16]). DARPA, known for its cutting-edge research and development in defense technologies, saw potential in applying AI to enhance emergency response mechanisms.

DARPA's Mission and Interest in AI

Matt Turek explains DARPA’s mission to create "strategic surprise" for national security ([04:41]), emphasizing the agency's role in pioneering advanced technologies. He was particularly interested in how AI could assist in battlefield triage, where rapid and accurate decision-making is crucial ([11:11]).

AI in Emergency Medicine: Potential and Challenges

Enhancing Decision-Making

The core idea explored in the episode is whether AI can support or even independently make triage decisions in emergencies. Turek envisions AI systems that possess comprehensive situational awareness, including real-time data on hospital resources, which can help optimize patient flow and treatment prioritization beyond human capacity ([20:10]).

Ethical Dilemmas: The Trolley Problem

A significant hurdle in implementing AI for triage is navigating ethical dilemmas similar to the famous trolley problem. AI systems must be programmed to handle scenarios where there are no clear right answers, such as deciding between saving one individual or multiple victims ([15:09]). Dr. Menes’ experiences highlight the complexity of these decisions, which often require nuanced judgment and moral reasoning that current AI systems struggle to emulate.

Training AI with Human Judgment

To address these challenges, DARPA is developing the Intelligent Triage Management (ITM) program. This initiative uses virtual reality (VR) simulations to train AI systems based on real-life decision-making processes of emergency doctors. Participants navigate realistic scenarios, allowing AI to learn from their responses and ethical considerations ([19:11]).

Current Developments and Future Prospects

Virtual Reality Simulations

DARPA's approach includes immersive VR simulations where medical professionals engage in scenarios that mimic real mass casualty events. These simulations present AI systems with complex decision-making situations, enabling them to learn from human expertise and ethical reasoning ([19:38]).

Extending Medical Capabilities

Turek envisions AI systems that can manage vast amounts of data and resources, providing doctors with optimized treatment plans and resource allocation. Such systems could significantly reduce response times and improve patient outcomes by offering insights that might not be immediately apparent to human practitioners ([20:39]).

Trust and Adoption in the Medical Community

Despite the technological advancements, gaining the trust of medical professionals remains a critical barrier. Dr. Menes expresses cautious optimism, acknowledging the potential of AI while recognizing the importance of human oversight: “[22:01]"If it is what I envision, yes. I think that the technology can keep up and eventually do something to this..."

Conclusion

The episode of "Click Here" effectively highlights the promising yet challenging role of AI in emergency medical settings. Through the harrowing experiences of Dr. Kevin Menes and the innovative efforts of DARPA, listeners gain insight into how AI could revolutionize triage and decision-making in critical situations. However, the integration of AI into such sensitive areas requires careful consideration of ethical implications, trust-building within the medical community, and the development of systems capable of nuanced human-like judgment.

Notable Quotes:

Dr. Kevin Menes ([01:18]): “You wouldn't make it through training if every heart attack that came in you, you freaked out and went into the corner, curled up and cried...”
Matt Turek ([12:36]): “How do we build AI systems that can capably make these ethical decisions?”
Dr. Kevin Menes ([22:01]): “If it is what I envision, yes. I think that the technology can keep up and eventually do something to this...”

Implications:

As AI continues to advance, its potential to support and enhance emergency medical decision-making becomes increasingly significant. The collaboration between medical professionals and AI researchers like Matt Turek could lead to breakthroughs that save lives and optimize emergency responses. However, the journey towards fully integrating AI into such critical roles demands rigorous testing, ethical considerations, and the establishment of deep trust between technology and its human users.

This summary captures the essence of the "Click Here" podcast episode, providing a comprehensive overview of the discussions and insights shared by Dr. Kevin Menes and Matt Turek regarding the role of AI in emergency medical decision-making.