The primary reason for the development of the PFC documentation is to enable the medic to more effectively and more efficiently take care of a patient beyond anticipated timelines. When we designed the PFC flowsheet, we wanted a single document that a medic could laminate and stick in the back of their aidbag, hopefully, without ever having to pull it out except for in training. Ideally, every patient would receive a quick evacuation and the medic would only have to do good TCCC. Since we know that this is not the case, the PFC documentation was custom built to enable anyone, regardless of level of training and proficiency, to help improve what they were already doing. Non-Medics, Resuscitation teams, Medics, it doesn’t matter. When technology fails, and it will, we think that having a dedicated, analog record of treatment can help reduce the cognitive burden faced by a small team who is most likely tired, and overwhelmed. The integrated checklists and visual reminders should act as cues to action.
The following should be viewed like a checklist to help jump start any tactical medical program to accommodate prolonged field care situations. Most of these concepts are discussed in separate posts and papers but are compiled here specifically to address questions on how to start from scratch. Special equipment acquisition should only be considered after identifying gaps in training, planning and practice. While there are still some gaps which we are working to fill, I hope some of this helps.
The conversation delves into the complexities of medication stability, particularly focusing on how environmental factors can affect the efficacy of pharmaceuticals. It highlights the stringent storage parameters set by pharmaceutical companies and the lack of testing in combat-simulated environments, raising concerns about medication reliability in critical situations.
In this episode of the PFC Podcast, Dennis interviews Nicholas Samuels, a humanitarian worker in Ukraine, discussing the critical aspects of medic safety, planning for evacuations, and the importance of understanding the broader context of the ongoing war. Nicholas shares insights on the challenges faced by medical volunteers, the necessity of being aware of threats like drone warfare, and the balance between mobility and capability in medical operations. He emphasizes the need for thorough planning, patience, and the importance of gathering accurate information before engaging in humanitarian efforts.
In this episode of the PFC Podcast, Dennis and Ben Garfin discuss the critical importance of clinical experience for combat medics. They explore the challenges and benefits of clinical rotations, the need for real-world experience, and the design of effective training programs. The conversation emphasizes the necessity of mentorship, the legal and ethical considerations of international rotations, and the overall goal of improving the current system for medics to ensure they are well-prepared for real-life medical situations.
In this episode of the PFC Podcast, Dennis and Jennifer Gurney discuss the critical aspects of wound management in trauma care, particularly in military settings. They cover the importance of cleaning wounds, the risks associated with early closure, effective irrigation techniques, and the role of nutrition in healing. Jennifer shares insights on Dakin’s solution, debridement strategies, and innovative approaches like using honey as a wound adjunct. The conversation emphasizes the need for proper assessment and management of complex wounds, as well as the importance of education on tourniquet use and ischemia risks.
In the face of rising global instability, authoritarian resurgence, and hybrid warfare threats, resistance movements and irregular warfare practitioners face profound challenges—not only in confronting oppression, but in doing so while sustaining their people, preserving legitimacy, and withstanding long-term attrition. One of the most fragile elements in any resistance effort is medical support—and it is often the most targeted by hostile regimes.
To help address this critical gap, we’ve developed the “Medical Support to Irregular Warfare” GPT—a customized AI advisor built specifically to support practitioners of irregular warfare, civil resistance organizers, medical planners, and defense policymakers operating in contested, denied, or occupied environments.
Click the Logo or paste the link and try it out:
What This GPT Is (and Is Not)
This GPT is not a general-purpose chatbot. It is an integrated analytical and advisory tool trained and guided to deliver medical, operational, and strategic insights grounded in the realities of irregular warfare. It synthesizes best practices from:
- U.S. Army Special Operations Command’s ARIS publications
- NATO and allied doctrine on comprehensive defense
- Historical and contemporary case studies from occupied Europe, Ukraine, Southeast Asia, and more
- Modern doctrine on Tactical Combat Casualty Care (TCCC) and Prolonged Casualty Care (PCC)
- Resistance medical support concepts such as guerrilla hospitals, auxiliary networks, and denied-area logistics
This GPT is not for clinical diagnosis or peacetime medical advice. It exists solely to serve communities preparing for or engaged in resistance and irregular warfare in complex, high-threat environments.
Core Directives: Security First, Legitimacy Always
The GPT has been directed to prioritize security above all else. In environments where even seeking information can be dangerous, the GPT will always:
- Prioritize force protection and network survival
- Recognize and highlight operational risk and exposure points
- Recommend secure communications, medical caching, and clandestine care models
- Emphasize auxiliary structure design and compartmentalization to safeguard providers and patients
Secondary to security is legitimacy—the moral and legal foundation that distinguishes a resistance from insurgency. Medical support is often the most visible and most morally powerful function in a resistance movement. This GPT can assist resistance organizers in:
- Aligning care delivery with international humanitarian law
- Leveraging medical aid to win popular support and delegitimize occupiers
- Establishing code of conduct, triage ethics, and noncombatant care standards
Only after security and legitimacy are addressed does the GPT provide tactical or technical medical recommendations—always contextualized to degraded, austere, or nonpermissive environments.
Who This GPT Is For:
This GPT is purpose-built for:
- Resistance organizers designing clandestine or auxiliary medical networks
- Special Operations medical planners advising partner nations or resistance forces
- Civil defense coordinators in at-risk countries developing comprehensive defense plans
- Medical educators building grassroots resilience and prolonged care training
- Think tanks and NGOs supporting irregular warfare policy and humanitarian frameworks
Whether you are preparing a SOF liaison mission, building a Forest Brother-style network, or organizing a community for total defense, this GPT can guide you through planning, training, equipping, and operational problem-solving.
How to Use This GPT for Maximum Effect
To optimally leverage this GPT:
- Treat it as a strategic advisor: Begin with your goals—population protection, casualty evacuation, legitimacy operations, or civilian resilience.
- Ask for systems, not just treatments: Don’t just ask how to treat a wound. Ask how to sustain trauma care in a village under surveillance. How to organize clandestine triage. How to store antibiotics in winter.
- Use it as a bridge between domains: It can help fuse tactical medicine, operational resistance planning, and strategic influence to build resilient networks.
- Integrate it into exercises and simulations: This GPT can simulate case scenarios, help stress-test your plans, or provide after-action reflections.
- Continuously adapt: The threat evolves. So must your preparation. Use the GPT to audit your plans against current doctrine and historical precedent.
A Tool for Integrated Deterrence and Comprehensive Defense
Resistance is not spontaneous. It is built—deliberately, in peace if possible. This GPT contributes to integrated deterrence by giving nations and communities the means to build the most human, resilient, and morally credible part of any resistance: life-saving care under fire and occupation.
When societies can survive, treat their wounded, protect their families, and hold on to hope, they do not surrender. This GPT exists to help ensure that outcome.
For the fighters, for the healers, for the planners—and for the people they serve—this tool is yours.
Risks
Use of this GPT—”Medical Support to Irregular Warfare”—by members of resistance movements or community-based medical teams carries significant operational, legal, and ethical risks. While it can be an invaluable tool for planning and education, its use must be measured and secure. Here are key risk categories:
1. Operational Security Risks
- Digital Surveillance: GPTs are cloud-based and require internet access. In occupied or hostile environments, use of internet-connected tools can expose resistance activity to enemy signals intelligence (SIGINT), metadata collection, or AI pattern analysis.
- Data Tracing: Even anonymized use can be correlated with local network behaviors. Adversaries with advanced cyber capabilities (e.g., Russia or China) may monitor tool usage patterns that reveal geographic clusters of resistance training or planning.
- Overreliance on External Systems: GPT responses are only as secure as the environment they’re used in. A compromised device, keyboard logger, or intercepted connection can betray an entire network.
2. Legitimacy and Legal Risks
- Violation of Domestic or Occupation Laws: In areas under authoritarian rule or foreign occupation, possession of resistance-related medical documents—even basic training guides—can be deemed subversive. This could lead to detainment, torture, or execution of personnel.
- Geneva Convention Considerations: While resistance medics should be protected under international humanitarian law, many regimes do not respect these rules. Being associated with resistance activity—especially violent acts—can strip away protections in the eyes of the oppressor.
3. Tactical Risk of Misinformation or Misapplication
- Medical Misinformation: GPTs do not substitute for hands-on training. Misunderstood or oversimplified medical guidance could cause harm (e.g., incorrect hemorrhage control, improper airway management), especially in pediatric, geriatric, or chemically contaminated cases.
- Loss of Context: Irregular warfare requires extremely localized knowledge. Generic guidance from AI may not account for terrain, cultural constraints, or access to materials, creating a false sense of confidence.
4. Dependency Risk
- Cognitive Offloading: Teams might delay or avoid developing independent doctrine, training SOPs, or local mentorship programs in favor of querying GPT. This impairs long-term sustainability and improvisation.
- Tool Fatigue or Overreach: Asking GPTs to make strategic or moral judgments (“Who should we prioritize for treatment in a mass-casualty event?”) can lead to distorted decision-making not aligned with local values or practical capabilities.
5. Adversary Exploitation
- Disinformation and Counter-Intelligence Risks: If adversaries gain access to the GPT’s output or impersonate it (e.g., via deepfakes or spoofed AI), they can sow confusion, mislead medical teams, or expose underground facilities and caches.
- Reverse Engineering: Should GPT logs or outputs be captured, adversaries could backtrack resistance medical protocols and deduce location, capability, or vulnerabilities.
Risk Mitigation Strategies
- Use GPT-generated knowledge offline after vetting and translating it into hardcopy doctrine.
- Maintain non-digital backups of all critical guidance.
- Treat GPT as a complement, not a replacement, for real-world, in-context medical and operational training like the Lithuanian SOF’s Guerilla Medicine course.
- Employ OPSEC discipline: If accessing GPT at all, use VPNs, burner hardware, and faraday-shielded environments.
Final Caution
This MARS GPT can help illuminate best practices, provide translations or doctrine comparisons, and serve as a knowledge multiplier. But in the context of irregular warfare, security and survivability must always override convenience and capability. Knowledge should empower—never endanger—the movement.
Sample prompts:
Also, please let me know how it works for you or if it needs tweaking in a certain direction or if anything is dangerous or inappropriate in your opinion.
If you are fluent in another language, try having it translate a response.
Bibliography
Here is the bibliography of the core references from which this custom GPT pulls.
What would you add? Send links in the comments and I’ll see if I can add them.
- Department of the Army. (2003). FM 3-05.201: Special Forces Unconventional Warfare Operations. Headquarters, Department of the Army.
- Department of the Army. (2013). ATP 3-05.1: Unconventional Warfare. Headquarters, Department of the Army.
- Department of Defense. (2000). DoDI 2310.6: Nonconventional Assisted Recovery in the Department of Defense. Office of the Secretary of Defense.
- NATO Special Operations Headquarters. (2020). Comprehensive Defence Handbook – Volume I. Mons, Belgium.
- Fiala, O. C. (2020). Resistance Operating Concept (ROC). JSOU Press.
- Hahn, T., et al. (2020). Special Topics in Irregular Warfare: Understanding Resistance. JHU-APL / USASOC.
- Ellison, J., Haider-Markel, D. P., Lauber, J. D., & Irwin, W. (2019). Governance: The Day After Overthrow. JHU-APL.
- Agan, B., Keras, C., Lyon, R., et al. (2019). The Science of Resistance. JHU-APL.
- Ryan, J., Lyon, R., & Irwin, W. (2019). Resistance and the Cyber Domain. JHU-APL.
- Irwin, W., & Mulholland, J. F., Jr. (2019). Support to Resistance: Strategic Purpose and Effectiveness. JSOU Press.
- Irwin, W., & Tovo, K. E. (2020). Decision-Making Considerations in Support to Resistance. JSOU Press.
- Irwin, W., & Cleveland, C. T. (2019). How Civil Resistance Works and Why It Matters to SOF. JSOU Press.
- Maher, B. (2023). A Plan B: An Australian Support to Resistance Operating Concept. Australian National University.
- Lyon, R. (2021). When the Golden Hour is Dead: Preparing Indigenous Guerrilla Medical Networks for Unconventional Conflicts (Master’s thesis, Naval Postgraduate School).
- Farr, W. D. (2006). The Death of the Golden Hour and the Return of the Future Guerrilla Hospital. JSOU Press.
- Jasinskas, M., Lyon, T., & Baker, K. (2022). UW medicine is the ultimate PFC. U.S. Army Medical Department Journal.
- Gurney, J., Lyon, T., & Jasinskas, M. (2024). The Survival Chain: Medical Support to Military Operations on the Future Battlefield.
- Lyon, R. (2021). ISIS medical system as a target for counterterrorism efforts. Journal of Special Operations Medicine, 11(2).
- Wade, R., & Erskine, A. (1969). The medical support of guerrilla forces. Military Medicine, 134(3), 210–217.
- Parker, G. (1946). The function and functioning of a surgeon in guerrilla warfare. Journal of the Royal Army Medical Corps, 86(1), 29–35.
- Brown, S., et al. (2025). Guerilla casualty care nodes and web networks on the future battlefield. Military Review Online Exclusive.
- Turbiville, G. H. (2005). Logistic Support and Insurgency: Guerrilla Sustainment and Applied Lessons of Soviet Insurgent Warfare. JSOU Press.
- Giannou, C., Baldan, M., & Molde, Å. (Eds.). (2019). War Surgery: Working with Limited Resources in Armed Conflict and Other Situations of Violence (Vol. 1, 2nd ed.). International Committee of the Red Cross.
- Giannou, C., Baldan, M., & Molde, Å. (Eds.). (2021). War Surgery: Working with Limited Resources in Armed Conflict and Other Situations of Violence (Vol. 2, 2nd ed.). International Committee of the Red Cross.
Joint Trauma System Clinical Practice Guidelines:
- Rapp, J., Keenan, S., et al. (2020). Sepsis Management in Prolonged Field Care (CPG ID: 83). Joint Trauma System.
- Van Wyck, D., Loos, P., et al. (2017). Traumatic Brain Injury Management in Prolonged Field Care (CPG ID: 63). Joint Trauma System.
- Dye, J., Shackelford, S., et al. (2020). Airway Management in Prolonged Field Care (CPG ID: 80). Joint Trauma System.
- Pamplin, J., Keenan, S., et al. (2017). Analgesia and Sedation Management during Prolonged Field Care (CPG ID: 61). Joint Trauma System.
- Wade, C. E., et al. (2016). Acute Extremity Compartment Syndrome and Role of Fasciotomy in Extremity War Wounds (CPG ID: 17). Joint Trauma System.
- Fisher, D., Shackelford, S., et al. (2018). Damage Control Resuscitation in Prolonged Field Care (CPG ID: 73). Joint Trauma System.
- Ostberg, N. P., Creson, K. D., & Loos, P. (2018). Nursing Interventions during Prolonged Field Care (CPG ID: 70). Joint Trauma System.
- Loos, P., et al. (2018). Documentation in Prolonged Field Care (CPG ID: 72). Joint Trauma System.
- Cancio, L., & team. (2016). Management of Burn Wounds under Prolonged Field Care. Journal of Special Operations Medicine, Winter 2016.
- Walters, T. J., et al. (2016). Crush Syndrome in Prolonged Field Care (CPG ID: 58). Joint Trauma System.
- JTS Ophthalmology Panel. (2017). Ocular Injuries and Vision-Threatening Conditions in PFC (CPG ID: 66). Joint Trauma System.
- JTS CPG Development Team. (2021). Mechanical Ventilation during Critical Care Air Transport (CPG ID: 48). Joint Trauma System.
- JTS CPG Development Team. (2020). Negative Pressure Wound Therapy during CCAT (CPG ID: 49). Joint Trauma System.
- JTS CPG Development Team. (2021). Infection Prevention in Combat-Related Injuries (CPG ID: 24). Joint Trauma System.
- JTS CPG Development Team. (2021). War Wounds: Debridement and Irrigation (CPG ID: 31). Joint Trauma System.
- JTS CPG Development Team. (2018). Wartime Thoracic Injury (CPG ID: 74). Joint Trauma System.
USASOC Assessing Revolutionary and Insurgent Strategies (ARIS) Publications:
- ARIS. (2016). Casebook on insurgency and revolutionary warfare, Volume I: 1927–1962 (Rev. ed.). USASOC.
- ARIS. (2012). Casebook on insurgency and revolutionary warfare, Volume II: 1962–2009. USASOC.
- ARIS. (2014). Case studies in insurgency and revolutionary warfare: Colombia (1964–2009). USASOC.
- ARIS. (1961/2013). Case study in guerrilla war: Greece during World War II (Rev. ed.). USASOC.
- ARIS. (1963/2013). Case studies in insurgency and revolutionary warfare: Cuba 1953–1959 (Rev. ed.). USASOC.
- ARIS. (1964/2013). Case studies in insurgency and revolutionary warfare: Guatemala 1944–1954 (Rev. ed.). USASOC.
- ARIS. (2015). Case studies in insurgency and revolutionary warfare: Algeria 1954–1962 (Rev. ed.). USASOC.
- ARIS. (2020). Case studies in insurgency and revolutionary warfare: Palestine series. USASOC.
- ARIS. (2014). Case studies in insurgency and revolutionary warfare: Sri Lanka (1976–2009). USASOC.
- ARIS. (2015). Case study: The Rhodesian insurgency and the role of external support (1961–1979). USASOC.
- ARIS. (2017). Unconventional warfare case study: The relationship between Iran and Lebanese Hizbollah. USASOC.
- ARIS. (2013). Human factors considerations of undergrounds in insurgencies (2nd ed.). USASOC.
- ARIS. (2013). Undergrounds in insurgent, revolutionary, and resistance warfare (2nd ed.). USASOC.
- ARIS. (2015). Legal implications of the status of persons in resistance. USASOC.
- ARIS. (2016). Narratives and competing messages. USASOC.
- ARIS. (2016). Special topics in irregular warfare: Understanding resistance. USASOC.
- ARIS. (2014). Threshold of violence. USASOC.
- ARIS. (2017). Irregular warfare annotated bibliography. USASOC.
- ARIS. (2016). Little green men: A primer on modern Russian unconventional warfare, Ukraine 2013–2014. USASOC.
- ARIS. (2014). Hybrid structures [White paper]. USASOC.
- ARIS. (2014). Counter-unconventional warfare [White paper]. USASOC.
- ARIS. (2016). Unconventional warfare pocket guide (v1.0). USASOC.
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In this episode of the PFC Podcast, Dennis and Kevin discuss the complexities of using narcotics in long-term care, particularly in a military or austere environment. They delve into the importance of understanding drug metabolites, context-sensitive half-times, and the implications for patient care. The conversation covers various anesthetic agents, their effects, and the clinical considerations necessary for effective pain management and sedation during and after surgical procedures.