This article is for military medics and combat medical personnel. No prior reading of the medical station articles is required. The LSCO system runs independently on front-line devices, separate from but interoperable with medical station systems.
Quick Start — Front-Line Treatment Checklist
| # | When | Module | Action |
|---|---|---|---|
| 1 | Casualty arrives | TCCC | Fill out DD1380 casualty card |
| 2 | Prolonged care needed | PFC | Create 72hr care plan |
| 3 | Transfusion needed | WBB | Register donor + issue blood |
| 4 | Evacuation needed | MEDEVAC | Submit 9-Line request |
| 5 | Reaching medical station | TCCC | "Evacuate to station" — one-tap transfer |
What Is LSCO?
LSCO (Large-Scale Combat Operations) is a field medicine module for front-line medics and combat medical personnel. It handles everything before the medical station — from the moment a casualty is found on the battlefield to their evacuation to a rear medical facility.
The LSCO PWA is accessible from the Gateway Lobby or directly via the /lsco/ path in the browser.
It contains five core modules:
| Module | Purpose | When to Use |
|---|---|---|
| TCCC | Tactical Combat Casualty Care — DD1380 card | Casualty arrives, document injuries and treatment |
| PFC | Prolonged Field Care — 72hr care plan | Evacuation delayed, continuous monitoring needed |
| WBB | Walking Blood Bank — emergency field donation | Casualty needs blood, no blood bank available |
| MEDEVAC | Medical Evacuation — 9-Line format | Casualty needs evacuation to medical station |
| Permission | Permission escalation — Peacetime/Emergency/Wartime | Situation escalates, broader operational authority needed |
Patient Journey: A Soldier from Injury to Evacuation
It's 9 AM. A soldier is wounded on the front line. The medic reaches the scene and opens the LSCO PWA on their phone.
Module 1: TCCC Casualty Card
TCCC (Tactical Combat Casualty Care) is the standard combat casualty care protocol. The casualty card (DD1380 format) is its most critical document.
The medic fills out:
- Casualty identity: name, rank, unit
- Injury classification: location, type (penetrating/blast/burn, etc.)
- Treatments performed: tourniquet, chest seal, IV access, etc.
- Medications administered: morphine, antibiotics, etc.
Once complete, the system generates a QR code. The next medical provider in the chain can scan this code to instantly import all casualty card data — no verbal handoff needed, no information lost in transit.
Module 2: PFC — Prolonged Field Care
If evacuation is delayed (bad weather, active combat, insufficient transport), a casualty may need to stay at the front line for hours or longer. This is when PFC (Prolonged Field Care) comes in.
The PFC module lets the medic create a 72-hour care plan:
- Scheduled vitals: BP/HR/SpO2/GCS, with system reminders for the next measurement
- Critical vitals auto-alert: if GCS drops or blood pressure crashes, the system flags an alert immediately
- Medication tracking: ongoing IV fluids, antibiotic schedules
- Break-glass emergency recording: if the situation is too urgent for normal documentation, the medic can activate emergency mode — fill in details later, never block current treatment
Module 3: Walking Blood Bank
There's no refrigerator, no blood bank on the front line. But the casualty needs blood. The WBB (Walking Blood Bank) lets the medic recruit donors from available personnel on-site.
Workflow:
- Register donor — name, blood type, health confirmation
- Record donation — collection time, volume
- Issue to casualty — record the transfusion
The system automatically blocks repeat donations within 56 days. This protection cannot be overridden — not even under wartime permissions — because excessive donation frequency endangers the donor's safety.
Module 4: MEDEVAC
Once the casualty is stabilized (or even if unstable but requiring higher-level care), the medic submits an evacuation request.
MEDEVAC requests use the 9-Line format — the NATO standard for medical evacuation calls. The system guides the medic through each line:
- Location of pickup site
- Radio frequency and call sign
- Number of patients by precedence
- Special equipment required
- Number of patients by type
- Security at pickup site
- Method of marking
- Patient nationality
- Terrain description
From Front Line to Medical Station
When transport arrives and the casualty is ready for evacuation, the medic taps "Evacuate to Medical Station" in the TCCC module.
This single action does three things:
- Automatically creates a patient record in the medical station's CIRS system
- Automatically registers as STAT (highest priority)
- Imports the complete TCCC card + PFC care records
The nurse at the medical station opens the Nurse Station PWA and sees the new patient already there, with full front-line treatment history attached.
From there, the workflow continues as described in Articles 2 and 3: physician consultation → surgery/prescription → pharmacy/blood bank → discharge or further evacuation.
Permission Escalation
The LSCO system has three permission levels:
| Level | Name | Effect |
|---|---|---|
| PEACETIME | Peacetime | Full approval workflows, all actions require confirmation |
| EMERGENCY | Emergency | Simplified approval for some workflows |
| WARTIME | Wartime | Maximum operational flexibility, post-hoc audit replaces pre-approval |
Permission escalation has one critical constraint: you cannot approve your own escalation request. A second authorized person must confirm it. This is by design — even in the most urgent situations, major permission changes require dual confirmation.
Frequently Asked Questions
Permission escalation is blocked? The system requires a second person to confirm. Find another authorized colleague to approve the escalation. This is a security mechanism, not a malfunction.
QR code won't scan? You can manually enter the casualty card ID (shown in the upper right corner of the card page). The QR code is a convenience shortcut, not the only way to transfer data.
"Evacuate to station" button not responding? Verify the medical station's CIRS service is running. If the front-line device and station aren't on the same network, the evacuation action is queued locally and syncs automatically once connectivity is established.
PFC vitals reminders aren't appearing? Check that your phone's notification permissions are enabled and the browser hasn't been killed by the OS in the background. If notifications are unreliable, set a physical alarm as backup.
Is the patient ID the same on the front line and at the station? During evacuation, the system creates a new station-side ID but retains the front-line TCCC card ID as a reference. Records on both sides can be cross-referenced.
Series Navigation
This is the fourth article in the xGrid Field Station Operations Guide series. Full series:
- Three Minutes to Online — From Power-On to a Fully Operational Station
- The Patient Journey — From Triage to Discharge
- Surgery and Transfusion — Managing Critical Cases
- LSCO Battlefield Medicine — A Field Medic's Operations Manual (this article)
- Daily Operations — Inventory, Blood Bank, and Shift Handoffs
That covers the front-line story. The final article returns to the medical station for daily operations: inventory management, blood bank tracking, and shift handoffs.