Damage Control Resuscitation Ukraine: Small Unit Training in Large Scale Combat Operations, Lessons Learned/Shared and Future Directions

In the summer of 2024, the College of Remote and Offshore Medicine, in partnership with TacMed North, conducted a Damage Control Resuscitation (DCR) training program in Ukraine, designed to address the challenges of prehospital care in large-scale combat operations. This review outlines the training structure, key outcomes, and lessons learned, highlighting the integration of bilingual instruction, competency-based skill reinforcement, and a train-the-trainer approach to enhance local medical capacity. Given the realities of prolonged casualty care and evacuation delays in Ukraine, the curriculum incorporated elements of prolonged field care alongside core DCR principles. The findings emphasize the clinical need for standardized pre-hospital training, continuous skills assessment, and, in future, should expand on these foundations to further develop scalable, adaptable medical training in conflict zones.