Search

Modern conflict and terrorist events have moved from linear two-dimensional battlespaces into complex, continuously evolving three-dimensional environments. Contested spaces make traditional definitions of zones of response confusing and lead to delays in care. The presence of actual or perceived ongoing threats creates an environment in which the initiation of tactical field care (TFC) may be inappropriate, despite the absence of an immediate risk to life. This risks a 'time and space gap' between care under fire and TFC. Major haemorrhage, airway, respiration, analgesia is proposed as a rethought approach to care in such environments., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

November 2018 saw the deployment of a medical team with a remit to provide far forward medical support to UK, Coalition and indigenous forces. The delivery of this capability demanded a solution unique within the UK Defence Medical Services. The 'light role' casualty collection points provided emergency medical care to 475 casualties over a 4-month period. The success of the deployment was dependant on the ability to remain light and agile which brought with it logistical considerations. The clinical caseload was predominantly secondary blast injury and gunshot wound (GSW). The positioning of a Role 1 facility close to the front line of troops enabled early Damage Control Resuscitation including the delivery of blood products. MEDEVAC to Role 2 was enabled by indigenous forces. The unique situation demanded bespoke solutions for documentation and blood warming. The lessons learnt during the deployment may form a blueprint for future contingency operations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)