Care under Constraint: Translating Medical Lessons from Ukraine into Civilian EMS Practice

Abstract

The war in Ukraine has generated significant insights into trauma care under conditions of prolonged evacuation, persistent threat, and constrained resources. These conditions have forced a redefinition of prehospital care, emphasizing adaptability, prolonged management, and decentralized capability. While civilian EMS systems operate in different environments, they increasingly encounter similar constraints during rural operations, disasters, and system overload. This article expands on key lessons identified from first-person experience in Ukraine and provides detailed analysis of their implications for civilian EMS systems. Practical recommendations are offered to improve resilience, clinical performance, and patient outcomes in austere, low-resource, and high-demand settings.

Introduction

Webinar Ambulance Security: Preventing Vehicle Theft and Understanding the Consequences

APRIL 28, 2026 10:00 AM MDT

REGISTER HERE.

Ambulance theft is no longer a rare or isolated event—it is a predictable and growing operational risk.  Industry data suggests that an ambulance is stolen approximately every two weeks in the United States, most often from hospital ambulance bays, but increasingly from active scenes. What was once considered an anomaly is now presenting serious and escalating consequences—including police pursuits, spike strip deployments, vehicle crashes, and situations where patients and crews are placed in harm’s way.

The uncomfortable truth is this: many of these incidents are preventable.  This timely and practical webinar brings together operational leadership, regulatory insight, and legal expertise to examine ambulance security from every angle—what’s happening, why it matters, and what you can do about it now.  The Academy of International Mobile Healthcare Integration (AIMHI), Pro EMS and Page Wolfberg & Wirth Advisory Group (PWWAG) are teaming up to help you address this issue. 

Ambulance Crashes: Increasing Clinician, Patient and Public Safety
Guidance on Seat Belt Use, Lights and Sirens and Fatigue

Too often, EMS clinicians, patients and others are injured or killed in ambulance-involved crashes. Crash Responder Safety Week is an opportunity to focus on safety practices around seat belts and restraints, lights and sirens use and fatigue mitigation to protect responders and the public.

EMS Leadership Charts New Course: Focus on Financial Sustainability, Workforce Resilience and Advocacy

The EMS Chiefs, Managers, and Directors (CMD) met in Colorado Springs on September 24, 2025, for a crucial brainstorming and prioritization session, aimed at defining future educational topics and initiatives for EMS leaders. The discussions were detailed, honest and invigorating.

The day-long retreat was sponsored by Jon Cloutier, CEO and founder of LifeMed SAFETY. A paramedic himself, Jon has been active in EMS for decades and we extend our gratitude for his support of the EMS Chiefs, Managers, and Directors section of EMSAC. LifeMed Safety is a full-service EMS equipment partner — offering new and re-certified equipment sales, certified maintenance, preventive service programs, and rapid repairs.

Conclusions of the State Interfacility Transport Task Force
By Scott Sholes
EMS Chief, Durango Fire-Rescue

According to a first-of-its-kind study of interfacility transport (IFT) in Colorado, EMS systems have experienced sharp increases in IFT demand in the past 5 years. Not only has the number of trips increased by 25% during that period, the time required to complete each trip now averages close to 2 hours.  The study, a combination of data analysis by CDPHE and statewide research by Sarah Weatherred (CMRETAC) and Austin Wingate (Grand County EMS), revealed in addition to putting a significant strain on Colorado EMS systems, IFTs present significant safety concerns for patients and providers.