Care Without Evacuation: The Reality of Prolonged Casualty Care

Humanitarian & Disaster Medicine, Military & Tactical Medicine
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What happens when evacuation is delayed, resources are limited, and definitive care is hours or even days away?

In this webinar, Travis Kaufman joins World Extreme Medicine’s Eoin Walker to explore the realities of Prolonged Casualty Care (PCC) and the clinical, operational, and human challenges of caring for patients when evacuation is not immediately possible.

Drawing on more than 25 years of military, disaster response, and humanitarian experience across over 70 countries, Travis shares lessons from conflict zones, remote environments, disaster settings, and healthcare systems operating under extreme pressure.

The session explores how clinicians can move beyond the traditional “golden hour” mindset and adapt to providing sustained care over extended periods, often with limited personnel, equipment, and evacuation options.

Topics covered include:

• Principles of Prolonged Casualty Care (PCC)
• Clinical decision-making during delayed evacuation
• Triage and resource prioritisation in austere environments
• Managing infection, hypothermia, shock, and physiological decline over time
• Nursing care considerations during extended patient management
• Human factors including fatigue, leadership, communication, and cognitive load
• Lessons learned from Ukraine, disaster response, and remote medicine
• Practical approaches to preparing for prolonged care scenarios

Whether you work in expedition medicine, humanitarian response, emergency medicine, military healthcare, wilderness medicine, or disaster management, this session offers valuable insights into delivering care when help is not immediately available.

Discover the PCC Course in Partnership with The WEM Fund.

Connect with Travis via LinkedIn.

More Information

Length: 46m
Guests: Travis Kaufman
Host: Eoin Walker

Intended Learning Outcomes

By the end of this session, participants should be able to:

  1. Define Prolonged Casualty Care (PCC) and explain its role when evacuation is delayed, denied, or unavailable.
  2. Differentiate between conventional pre-hospital care and the extended care requirements associated with prolonged casualty management.
  3. Recognise the operational challenges that influence casualty care in remote, disaster, humanitarian, and conflict environments.
  4. Apply principles of triage, resource stewardship, and prioritisation during prolonged care scenarios.
  5. Identify common physiological threats that emerge over extended timelines, including hypothermia, infection, thrombosis, respiratory complications, and metabolic disturbances.
  6. Discuss strategies for monitoring patient trends and anticipating deterioration when definitive care is delayed.
  7. Understand the importance of nursing care interventions, including repositioning, hygiene, hydration, nutrition, and pressure injury prevention during extended patient management.
  8. Evaluate the impact of human factors such as fatigue, cognitive overload, communication, leadership, and team dynamics on clinical performance.
  9. Explore practical approaches to adapting equipment, resources, and clinical interventions in austere and resource-limited settings.
  10. Reflect on how lessons from military medicine, humanitarian response, and remote healthcare can be translated into civilian clinical practice.

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