01T+00:00
Casualty event at the front
A casualty occurs on the forward edge: combat zone, contested industrial site or remote disaster area. Position is fixed, the alert goes out. The clock starts.
From Point of Injury to extended care.
Five operational steps turn a standard medical kit into a configured, drone-delivered prolonged casualty care capability. Every step is timed, documented and reproducible across operator skill levels.
Problem setting
Denied areas, delayed evacuation.
In certain types of warfare, getting medical logistics to the patient is the challenge. Denied areas, because of terrain, weather, the type of warfare or other circumstances, are sometimes simply not reachable with conventional medical and logistical means. Ambulances cannot get close enough, there is no air superiority so helicopters cannot fly, the area is saturated by drones, or the only road into a disaster area is cut.
Large-scale combat operations can combine all of these problems, and evacuation may then take 24 hours or more. Timely care is the basis of military medicine; modern conflicts put the medical timeline under pressure.
What large-scale combat in Ukraine shows
- Immediate self aid and buddy aid under threat
- Limited training for conscripts
- Delayed access to trained medical personnel
- Damage control surgery often delayed by prolonged evacuation
- Medical facilities and personnel deliberately targeted
- Evacuation windows extending well beyond doctrinal timelines
- Disrupted or degraded communications due to electronic warfare
- Damaged infrastructure and disrupted supply routes
24h+
Evacuation windows
When helicopters cannot fly and ambulances cannot approach, evacuation can stretch well beyond doctrinal timelines, in some scenarios to 24 hours or more. Prolonged casualty care then becomes a realistic requirement.
T+0
Time to first intervention
Haemorrhage control, airway management and early resuscitation are time-critical. The kit's screen activates on opening and sequences these first steps for the responder immediately.
EW
Comms-denied
Electronic warfare means live telemedicine cannot be assumed. Guidance has to work on the kit itself, with no uplink at all.
0
Medics at the point of injury
The first person on scene is a buddy, a soldier or a volunteer with limited medical training. They need to act correctly, in the right order, under pressure.
Timeline adapted from NATO AJMedP-1 and JTS prolonged casualty care guidance. In contested environments the distance between Point of Injury and a medical facility may be short, yet evacuation may still take many hours.
From a medical perspective
- Haemorrhage control, airway management and resuscitation are time-critical interventions.
- Current guidelines emphasise early blood product availability and damage control resuscitation for severe haemorrhage.
- The first person on scene often has limited medical training and needs structured guidance and the right materials.
- Forward, timely availability of guidance and resources is therefore the design goal of ResCura Tactical.
Role 1 · forward care
Basic equipment, stabilisation, limited advanced care and preparation for evacuation. ResCura Tactical extends what Role 1 can do when evacuation to Role 2 is delayed beyond doctrine.
The workflow
From Point of Injury
to extended care.
Five operational steps turn a standard medical kit into a configured, drone-delivered prolonged casualty care capability. Every step is timed, documented and reproducible across operator skill levels.
02T+01:30
Stabilisation at the Point of Injury
The first responder opens the ResCura kit. The screen activates and walks them through haemorrhage control, airway and breathing in the correct order, following TCCC / MARCH and ABCDE.
03T+02:30
Evacuation request and medical handover
Two different messages leave the point of injury. The 9-line is the evacuation request (location, radio, number and precedence of patients, equipment, security, marking). The MIST report is the medical summary (Mechanism, Injuries, Signs, Treatment given). ResCura Tactical keeps them apart and supports each differently.
Generated by the kit
Time-stamped log of the guided steps completed; MIST summary compiled from the logged treatment and the vitals entered; time and position of the incident.
Entered by the responder
Mechanism and injuries, vital signs, and the 9-line fields (number of patients, precedence, security, pick-up site). The 9-line is sent through the unit's normal radio procedure.
In development
Automatic transmission of the MIST summary and position to medical command over 4G / LTE-M where uplink exists; automatic vital-sign capture; live telemedicine with bidirectional video.
In developmentThe offline guided protocols and the treatment log are the core capability today. Connected features are developed under the ResCura Tactical Aegis programme and are marked as such.
04T+04:00
Kit configuration by the medic (Aegis)
Based on the MIST summary, the medic at command configures a ResCura Tactical Aegis kit for this specific casualty: blood products, intraosseous access, advanced airway, medication. Case-specific protocol steps and dosages are loaded onto the kit's touchscreen before dispatch.
In developmentSteps 4 and 5 describe ResCura Tactical Aegis, in development, planned for Q3 2027.
05T+08:00 → 24h+
Drone delivery and extended care (Aegis)
The configured kit flies directly to the casualty's coordinates, bypassing routes that are blocked or under fire. On arrival the first responder opens it and the pre-loaded protocol takes over: vascular access, transfusion, airway, continued resuscitation and documented monitoring until evacuation, which may still be hours away.
In developmentSteps 4 and 5 describe ResCura Tactical Aegis, in development, planned for Q3 2027.
The impact
When conventional logistics can no longer operate, the kit still guides.
Extends reach
Brings structured protocols and configured materials to the point of injury.
Supports timely action
Activates on opening and sequences the first interventions when evacuation is delayed.
Guides interventions
Step-by-step guidance for haemorrhage control, airway, breathing and reassessment, logged as performed.
Supports caregivers
Enables non-medics to follow advanced protocols with guidance and documented handover.
Doctrine and evidence
Grounded in published doctrine.
The problem statement and the protocol logic behind ResCura Tactical follow NATO medical planning doctrine, the TCCC and JTS clinical practice guidelines and the published evidence on time to resuscitation.
- NATO (2019) AJMedP-1 Allied Joint Medical Planning Doctrine. Brussels: NATO Standardization Office.
- Butler, F.K., Holcomb, J.B., Giebner, S.D., McSwain, N.E. and Bagian, J. (2017) 'Tactical Combat Casualty Care (TCCC) Guidelines 2017'. Journal of Special Operations Medicine, 17(2), pp. 8–11.
- Cap, A.P., Spinella, P.C., Borgman, M.A., Blackbourne, L.H. and Perkins, J.G. (2018) 'Damage control resuscitation'. Military Medicine, 183(suppl_2), pp. 36–43.
- Shackelford, S.A. et al. (2023) 'Association of time to initial resuscitative intervention with mortality in trauma patients at risk for hemorrhage'. Journal of Trauma and Acute Care Surgery.
- Shackelford, S.A. (2025) 'Time-critical trauma care and early intervention', lecture delivered at Tactical Battlefield Symposium, Zermatt.
- U.S. Department of Defense, Joint Trauma System (2024) Clinical Practice Guidelines, incl. Prolonged Casualty Care. jts.health.mil.
- Watling, J. and Reynolds, N. (2023) Meatgrinder: Russian tactics in the second year of its invasion of Ukraine. London: Royal United Services Institute.
- World Health Organization (2024) 'Grim milestone on World Humanitarian Day: WHO records 1940 attacks on health care in Ukraine since start of full-scale war'.
- The Guardian (2025) 'Underground hospital treats Ukrainian soldiers injured by Russian drones', 25 October.
Contact
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