УКР 
A recent analytical article published in the journal Military Medicine offers a fundamental rethinking of combat medical care in the context of modern, full-scale warfare. Among the co-authors are Ukrainian experts with firsthand battlefield experience: Major General Kostiantyn Humeniuk, Chief Surgeon of the Armed Forces of Ukraine and professor at the Ukrainian Military Medical Academy, and Dr. Denys Surkov, medical director of tactical medicine programs at the Ukrainian Council on Resuscitation and the Tactical Medicine School of the 184th Training Center of the Ukrainian Ground Forces.
Rethinking the Battlefield Reality
As Dr. Surkov explains, NATO’s current model of military medicine — largely shaped by limited regional conflicts — falls short in the face of Ukraine’s full-scale war.
The full-scale invasion has changed a lot of things:
– The front line is unstable.
– Rear areas are regularly under attack.
– Helicopters are no longer safe transport — they’re targets.
– Evacuation routes are not fixed or secure — they’re dynamic and dangerous.
“Drones Changed Everything. Modern warfare is becoming robotic,” adds General Humeniuk. Previously, based on NATO standards developed from local conflicts, the goal was to evacuate a wounded soldier within 60 minutes — the so-called "golden hour." But now, the authors stress, this concept has essentially lost its relevance, and the standards must evolve.
Major General Kostiantyn Humeniuk
Instead, they propose adopting the Prolonged Field Care approach — stabilizing the wounded in the field for an extended time until evacuation becomes possible.
“The battlefield is fully exposed. Helicopter evacuation was possible during the ATO/JFO period, but in modern warfare, it’s a challenge globally. It’s only viable under conditions of complete air superiority — and we don’t have that,” Humeniuk says. “Even armored vehicles are vulnerable. The future lies in ground-based evacuation drones — silent and hard to detect.”
The Tactical Level: Where Lives Are Saved
Dr. Surkov stresses that the tactical level has become the heart of the medical system:
“Traditional command models work top-down. But Ukraine’s experience shows that tactical teams make critical decisions in real time under fire. This is where all the pressure converges — limited resources, extreme risk, time-sensitive decisions. This is where flexibility, resilience, and innovation emerge — because centralized systems often can’t keep up.”
Dr. Denys Surkov
The war has also revealed the fragility of medical logistics. Surkov emphasizes that future training must prepare medics for autonomous decision-making, field-based logistics, and operating without rear support.
While Ukraine has developed unique combat medical expertise, Surkov notes that a NATO-style “staff culture” is still lacking.
“We need better coordination. Medics should be directly involved in operational planning — their voices must be heard. Medics must understand battlefield planning, and commanders must understand how medical evacuation works. Some Ukrainian units are already doing this — and their results in saving lives are strong.”