Optimization of prehospital care algorithms in cases of mass casualties among the civilian population

Abstract

Modern armed conflicts create mass casualty incidents that overwhelm peacetime Emergency Medical Services (EMS), demanding a strategic reorganization to preserve public health and national labor potential. This study aims to analyze the specifics of EMS operations during prolonged emergencies and propose optimization algorithms to enhance healthcare system resilience. Utilizing a systems approach and content analysis, the research evaluates Ukraine’s regulatory framework, civilian combat trauma statistics, and international standards (WHO, TECC) from 2023–2025. The analysis identified four critical optimization vectors: modifying algorithms for resource scarcity, implementing efficient medical triage (START/SALT), ensuring interagency coordination within a «unified medical space», and providing specialized tactical training (TECC) alongside psychological support for staff. Transitioning to these flexible, disaster-medicine principles allows EMS systems to maintain operational capacity despite logistics disruptions and secondary strike threats. Ultimately, implementing these structural adjustments minimizes permanent civilian losses and significantly reduces subsequent state social costs for long-term rehabilitation.