Management of trauma in remote and austere settings: civilian implications of military-derived prolonged field care principles - A narrative review.

Prolonged Field Care (PFC) refers to the delivery of advanced trauma care in austere environments when evacuation to definitive treatment is significantly delayed. Although originally developed within military medicine, its principles are increasingly relevant to civilian trauma systems operating in remote, rural, wilderness, disaster, and resource-limited settings. This narrative review provides an updated overview of PFC concepts and their potential applicability to civilian trauma care, focusing on key domains such as airway management, haemorrhage control, crush syndrome, analgesia and sedation, and telemedicine-supported decision-making. Current evidence suggests that PFC may provide a practical and flexible framework to maintain physiological stability, prevent secondary complications, and support clinical decision-making during prolonged rescue scenarios. Telemedicine may further enhance procedural safety and diagnostic capability in isolated settings. Despite the predominance of military-derived evidence, several PFC principles may be adaptable to selected civilian emergency systems, although important operational and logistical differences must be considered. Further research is needed to evaluate outcomes and support context-specific implementation in civilian practice.