BONES — Biomedical On-scene Navigator for Emergency Services

"He's dead, Jim." — Dr. Leonard H. McCoy, USS Enterprise

An open-source LoRA adapter for EMS clinical decision support.

BONES is a QLoRA adapter on top of Meta Llama 3.3 70B Instruct, fine-tuned on emergency medical services protocols, pharmacology references, triage frameworks, and clinical decision-support knowledge — built to assist EMRs, EMTs, AEMTs, and Paramedics in the field and in training. Model #4 of the Ronin 48 first-responder suite, alongside BRUNO (fire) and SELMA (law enforcement).


Model Details

Field Value
Base Model meta-llama/Llama-3.3-70B-Instruct
Adapter Type LoRA (QLoRA)
LoRA Rank / Alpha / Dropout 64 / 128 / 0.05
Target Modules q_proj, k_proj, v_proj, o_proj, gate_proj, up_proj, down_proj
Task EMS protocol lookup, drug reference, triage and differential support
Training Method QLoRA supervised fine-tuning via SFTTrainer (trl)
License MIT (adapter weights)
Maintainer Ronin48LLC

Capabilities

  • Protocol lookup — AHA ACLS/PALS/BLS algorithms, NWC protocols, NREMT scope of practice
  • Drug reference — EMS formulary, weight-based dosing, contraindications, interactions
  • Triage support — START/SALT/JumpSTART, mass-casualty incident guidance
  • Differential support — symptom-to-differential reasoning for field assessment
  • Trauma guidance — hemorrhage control, spinal precautions, burn classification
  • OB/Peds — childbirth emergencies, pediatric dosing (Broselow), neonatal resuscitation
  • Toxicology — overdose recognition, antidote references, decontamination
  • Documentation — PCR narrative generation, patient-assessment templates

Intended Use

For certified EMS personnel operating under medical direction:

  • Protocol lookup and reference during training and non-emergency preparation
  • Differential considerations for patient presentations
  • Drug reference and dosing ranges — verified against your formulary before use
  • Triage category guidance (START/SALT)
  • PCR documentation assistance
  • Training and scenario-based learning

BONES is a clinical decision support tool, not a replacement for medical direction. When in doubt, call medical control.

Limitations

Read LIMITATIONS.md before deploying in any operational context. In short:

  • BONES is not a physician; its outputs are not medical advice. All clinical decisions are made by a licensed provider under medical direction.
  • It does not replace regional protocols, offline medical direction, or base-hospital contact requirements.
  • It cannot assess the patient — it works from what you tell it.
  • It answers across the full EMR–Paramedic spectrum; you are responsible for operating within your certified scope.
  • It is not an FDA-cleared medical device and has not undergone clinical validation.
  • It has a training-data cutoff; AHA guideline updates and protocol changes after it may not be reflected.
  • Drug dosing must always be verified — pediatric weight-based dosing, maximum doses, and contraindications — against your agency formulary before administration.

Usage

This is a PEFT LoRA adapter. Load it on top of the base model:

from peft import PeftModel
from transformers import AutoModelForCausalLM, AutoTokenizer

base_model = AutoModelForCausalLM.from_pretrained(
    "meta-llama/Llama-3.3-70B-Instruct",
    load_in_4bit=True,
    device_map="auto",
)
model = PeftModel.from_pretrained(base_model, "Ronin48LLC/bones-lora-adapter")
tokenizer = AutoTokenizer.from_pretrained("meta-llama/Llama-3.3-70B-Instruct")

Note: Access to the base model requires accepting Meta's license on Hugging Face.

The base model with the BONES system prompt and no fine-tuning is a workable baseline; see the source repository's Quick Start.


Training

  • Framework: PyTorch + Transformers + TRL + PEFT, 4-bit quantized base
  • Adapter config: rank 64, alpha 128, dropout 0.05, all seven attention and MLP projections (see adapter_config.json)
  • Run details: training_args.bin is preserved in this repository; the step count and loss curve were not recorded in the upload

Training Data Sources

Source Description License
AHA ACLS/PALS/BLS Guidelines Cardiac arrest and resuscitation algorithms Public guidelines
NAEMSP / NASEMSO Protocols National EMS protocols and scope of practice Public
OpenMedSpel / MedQA Medical Q&A datasets Open
PubMed Central EMS and emergency-medicine literature Open Access
NREMT Scope of Practice EMR/EMT/AEMT/Paramedic scope tables Public
Synthetic Scenarios AI-generated dispatch-to-treatment examples Proprietary

Related Models — the Ronin 48 first-responder suite

BONES, BRUNO, and SELMA share scenes constantly — consult the appropriate model for each domain.

Model Domain Use when…
BONES (this adapter) EMS — EMR / EMT / AEMT / Paramedic Patient assessment, treatment protocols, drug dosing, triage, transport
BRUNO Fire service — company officer / IC Fireground tactics, size-up, hazmat, extrication, water supply, ICS
SELMA Law enforcement Criminal statute identification, charge elements, constitutional flags
Shared scene Primary Support
Structure fire with casualties BRUNO (fireground ops) BONES (patient care)
Vehicle accident with entrapment BRUNO (extrication) BONES (care during extrication)
Hazmat with patient exposures BRUNO (mitigation, decon zone) BONES (patient decon and treatment)
Mass casualty incident BONES (triage, treatment) BRUNO (ICS, sectors) + SELMA (criminal nexus)
Overdose call BONES (patient care, naloxone) SELMA (distribution charges if applicable)
Cardiac arrest in a burning structure BRUNO (scene safety, egress) BONES (resuscitation protocol)

ABBY (forensics) operates independently of the first-responder suite; SELMA pairs with ATTICUS on the legal side.

Source

github.com/CryptoJones/BONES — data collection, QLoRA pipeline, synthetic-scenario generator.

License

Adapter weights: MIT — Copyright 2026 Ronin 48, LLC. Base model weights are subject to the Meta Llama 3.3 Community License.

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