Improving medical care for defenders: the pre-hospital chain of care for the wounded
The Ministry of Defence of Ukraine continues its efforts to enhance the quality of medical care for wounded service members. One of the important aspects is ensuring thorough documentation and transfer of medical data during the pre-hospital stage.
To this end, the Ministry of Defence has implemented new primary medical documentation forms: the Primary Medical Record and the Casualty Card.
“These documents record the full continuum of medical care for service members — from the incident site to hospital admission. They also serve as the foundation for an integrated system of casualty registration and medical support,” stated Major of the Medical Service Dmytro Samofalov, Acting Head of the Health Department of the Ministry of Defence of Ukraine.
The Ministry of Defence offers a comprehensive overview of the ‘Primary Medical Record’ and the ‘Casualty Card.’
Primary Medical Record
This is a medical document confirming the provision of care at the pre-hospital stage. This form must accompany the service member throughout the treatment process and is used for reporting purposes.
It is filled out when a service member sustains an injury (wounding), falls ill, or is otherwise incapacitated, resulting in the inability to perform assigned duties or requiring temporary withdrawal from duty.
The record is maintained by medical staff in military units and institutions. When care is administered on an outpatient or inpatient basis, this form is not required for completion.
The Primary Medical Record must include:
- personal data of the service member
- unit designation
- type of wound or trauma
- Time of admission to the stabilization point, forward surgical facility, etc.
- scope of medical aid given during evacuation, etc.
“This document is essential in various medical situations:
during internal investigations of injuries (trauma), examinations by the Military Medical Commission (MMC), assessments by the Expert Teams for Assessing Daily Functioning, and for processing payments—including both additional remuneration (up to UAH 100,000) and one-time financial assistance in cases of disability or partial loss of working capacity.
- In cases where the military unit was not informed about a service member’s treatment and mistakenly classified them as AWOL, the Primary Medical Record and other medical documents help clarify the situation.
Technical preparations are currently underway to implement Form No. 001/o, the ‘Primary Medical Record’, through the Medical Information System of the Armed Forces of Ukraine. Personnel are also being trained on the correct procedure for completing the form.
Casualty Card
The form is filled out at the point of care during tactical pre-hospital treatment following an injury or trauma. It contains information on the wounded person’s condition, the care provided, and other essential details.
The card is included in the Individual First Aid Kit (IFAK). The care provider completes the form and ensures it accompanies the casualty during further evacuation. Filling out the Casualty Card is mandatory. The data it contains serves as a source for completing the Primary Medical Record. For now, the Card is maintained in paper format.
Both the ‘Primary Medical Record’ and the ‘Casualty Card’ play a critical role in ensuring the continuous collection and transmission of information from the incident site to hospitalization.
Based on this data, a centralized registry of casualties (wounded, injured, ill, affected) receiving medical care at the pre-hospital stage is formed.
Creating such a registry will facilitate:
- decision-making based on comprehensive medical data;
- quality of care through processing, analysis, and summarization of the collected information;
- more efficient resource planning and further actions in military medicine.
The development of systems for data collection, analysis, and generation is an ongoing process that requires cooperation and engagement from all parties involved in providing care, with the ultimate goal of enhancing medical support for our defenders.
Regulatory acts governing the ‘Primary Medical Record’ and ‘Casualty Card’.
Order of the Ministry of Defence of Ukraine No. 879 dated December 31, 2024, “On the Approval of Primary Medical Record Forms Used During Tactical Pre-Hospital Care and Pre-Hospital Medical Assistance in the Course of Military (Combat) Operations and Training of Security and Defence Forces for Their Designated Use”. The document sets forth:
1) Form No. 001/o: “Primary Medical Record”
2) Instructions on filling out Form No. 001/o, “Primary Medical Record”
3) Form No. 002/o: ‘Casualty Card’
4) Instructions on filling out Form No. 002/o, ‘Casualty Card.’