Wearable devices have grown to meet the demand for continuous, noninvasive vital signs monitoring in the military and civilian health care markets. These devices have largely excluded pulse oximetry because non-traditional sites, such as the chest, arm and legs, pose a challenge. We have previously demonstrated the ability to accurately monitor pulse oximetry on the chest, arms and calf. This project proposes to develop a wearable, secure wireless adhesive patch system to monitor pulse oximetry, respiration rate and other core vital signs from non-traditional sites. The system will provide real-time, continuous monitoring, and be able to withstand the physical environmental challenges of shock, dust, sand, and water. The battery-powered, wireless oximeter will transmit computed parameters and pulse oximeter photoplethysmograph (PPG) waveform to military-selected medic end user device (EUD). Data transmission to the EUD enables two features: simultaneous monitoring of multiple casualties; and development of predictive models and indices independent of the monitoring device. The wireless oximeter will include technological advancements such as miniaturization, reduced power consumption, high bandwidth wireless communication and enhanced measurement algorithms. These advances will lay the foundation for further development and testing in this rugged environment and integration beyond the medics EUD into larger medical record systems.