Hemorrhage control
Mechanical, endovascular and surgical control remain primary.
Applications · Military & Disaster Medicine · Prolonged Casualty Care
When evacuation is delayed, oxygen delivery becomes a logistics problem.
Severe hemorrhage begins immediately. Definitive blood and surgery may not. In contested, austere and disaster environments, the clinical problem can shift from moving the casualty faster to maintaining physiology longer while therapeutic capability moves toward — and potentially with — the casualty.
72 hCurrent U.S. Army prolonged-care planning expectation.
>96 hSelected U.S. Marine Corps patient-sustainment capability standard.
24 h–multiple daysProlonged casualty care reported in contemporary Ukraine.
5–7 dUSSOCOM prolonged field-care research horizon.
These values describe different operational observations, planning or training standards, and research horizons. They are not directly comparable evacuation-time averages and should not be read as one universal military standard.
01 / The operational gap
The Golden Hour cannot always be assumed.
Modern trauma systems were built around rapid evacuation toward blood and surgery. Drone-contested airspace, dispersed operations, damaged infrastructure, high casualty volumes and disrupted transport can extend the bridge from minutes toward hours and, in selected settings, days.
Injury→Stabilization→Holding→Continued treatment→Evacuation when possible→Definitive blood + surgery
02 / Function-based resuscitation
Hemorrhage is the loss of functions, not only the loss of fluid.
Whole blood remains the integrated biological reference when it is available. Severe hemorrhage simultaneously compromises volume, hemostasis, red-cell oxygen transport and ultimately tissue oxygen delivery. A function-based framework asks which biological function is becoming limiting and how it can be supported until definitive therapy becomes available.
Hemostatic support
Plasma, freeze-dried plasma and platelet systems address coagulation-related deficits.
Oxygen delivery
RBCs, whole blood and investigational oxygen carriers address the oxygen-transport function.
03 / Technology direction
More physiological capability per unit of mass, volume and infrastructure.
Prolonged field care makes the delivery architecture part of the therapy. Current military development increasingly emphasizes shelf stability, compact form factor, automation, reduced cold-chain dependence and the ability to continue treatment during patient movement. DARPA programs including FSHARP, GOLDEVAC and RAPIID independently illustrate this systems-level shift toward functional modularity and fieldable resuscitation.
04 / BHOC research relevance
Precision Oxygen Therapeutics for the interval before definitive blood.
BHOC — Biological Hemoglobin Oxygen Carrier — is proposed as an investigational Precision Oxygen Therapeutic concept focused on one defined biological function: oxygen delivery. The proposed operational direction is a compact treatment procedure with cartridge, closed controlled delivery, automated metering, practical vascular access and compatibility with patient movement.
Boundary: these are proposed research and engineering objectives, not established product-performance claims. BHOC has not been demonstrated here as an approved military treatment and should not be presented as a replacement for hemorrhage control, donor blood, transfusion or definitive surgical care.