Primary Medical Record Card: a new standard of pre-hospital care for service members

Beginning in February 2025, the Armed Forces of Ukraine introduced the Electronic Primary Medical Record Card (ePMRC) (Form No. 001/o) and the Casualty Card (Form No. 002/o). This is not merely replacing paper with digital tools; it represents Ukraine’s military medicine transitioning to NATO standards, establishing an evidence base for treating combat injuries, and safeguarding social justice for service members.

For decades, military medical record-keeping relied on the paper “Form 100,” which was often lost, unreadable, or incomplete in high-intensity combat. This resulted in a number of problems:

• For doctors: Lack of rapid visibility into medications already administered to the casualty at previous stages of care.
• For service members: Difficulty proving the fact of injury to obtain official war-related disability status or related state entitlements.
• For the system: Lack of statistical data needed to analyze the effectiveness of tourniquets, hemostatic agents, or evacuation methods.

Two medical record cards, one goal: how it works

The system is based on integrating two documents that accompany a service member from the moment of injury to a rear-area hospital.

Casualty Card (Form No. 002/o)

This document is completed during care provision, either under fire or in the nearest available shelter.

• Completed by: A combat medic, a combat lifesaver, or a fellow service member (self-aid or buddy aid).
• Description: A compact form made of special moisture-resistant and durable paper that can be written on even in rain or harsh field conditions.
• What it records: Injury mechanism, life-threatening hemorrhage, precise tourniquet application time, and administered painkillers or antibiotics.

The Casualty Card serves as the primary source document. Data from this paper card is subsequently entered into the electronic system.

Primary Medical Record Card (Form No. 001/o)

This medical document confirms that medical care was provided at the pre-hospital stage and is recorded in the Medical Information System of the Armed Forces of Ukraine (MIS AFU); paper-based documentation is permitted only in the absence of technical capability.

• Completed by: Qualified medical personnel at stabilization points (Role 1) and in forward surgical units (Role 2).
• Purpose: Consolidates comprehensive patient data, including diagnostic findings (laboratory diagnostics, eFAST ultrasound, radiography, etc.) and surgical procedures.

Data in the ePMRC is subject to a high level of protection against unauthorized interference.

• Retention period: 25 years.
• Access: Restricted to authorized medical personnel and the patient (or the patient’s legal representative) in accordance with personal data protection laws.

Key benefits

Implementing the Primary Medical Record Card and the Casualty Card establishes a unified information environment where data are used to save lives.

Most importantly, it minimizes medical errors. At the subsequent stage of evacuation, the physician can quickly determine which medications have been administered, known allergies, and blood type, even if the patient is unconscious. Beyond its medical function, this also serves as a legal protection tool. Real-time recording makes each entry incontestable proof of an injury sustained during a combat task, substantially streamlining examination by the Military Medical Commission (MMC) and access to applicable state entitlements.

In turn, medical personnel at all levels gain a tool that frees up time for what matters most—saving lives. Physicians work in a unified digital interface instead of completing paper forms.

For a combat medic, this provides a precise algorithm to ensure that the time of tourniquet application is not overlooked. For surgeons, it enables advance preparation of the operating room prior to the arrival of the medical evacuation vehicle, since patient status data are already accessible in the MIS AFU. This upholds the principle of continuity of care, whereby each subsequent evacuation stage builds logically on the previous one, based on verified data rather than guesswork.

At the system level, the ePMRC allows for the systematic collection of data on contemporary combat injuries. Through analysis of this data, the state will be able to refine treatment protocols, tailor NATO standards to the realities of full-scale high-intensity warfare, and optimize procurement decisions by identifying which tools—such as tourniquets, occlusive dressings (chest seals), or medications—have proven most effective in real combat conditions.