Medical Loadout
Deliverable SYS-012. Structure per cc02-standards/SYSTEM-STANDARD.md. Every component traces to a design basis and an acceptance criterion.
1. Purpose and Design Basis
1.1 Scope and Objective
What the medical program covers across the detail’s four kit echelons, and what stays out of scope.
The Medical Loadout defines the detail’s medical kit and equipment baseline as a priced system element, across four kit echelons: the individual first aid kit (IFAK) carried by every operator, the detail medical bag (team bag) carried by the designated detail medic on movements, the vehicle kit staged in each motorcade vehicle, and the residence or static-site kit staged at a fixed protected location. It sets the program-wide medical requirements (hemorrhage control, scope-of-practice bound, environmental adaptation, transportability, sustainment) that every echelon’s kit contents must satisfy, and it holds the priced bill of materials for the two echelons not already priced elsewhere in the model (the team bag and the residence/static kit). Out of scope: the clinical treatment protocol and jurisdiction-specific carriage determination for controlled and prescription items, which is EP-030’s; the training and certification program that establishes scope of practice, which is EP-029’s; and the individual IFAK and vehicle trauma kit component prices, which are already carried in SYS-009 and SYS-010 respectively and are cross-referenced here, not re-priced, to avoid double-counting in the BIZ-013 rollup.
1.2 Design Basis
Why the program is organized as four echelons rather than one kit, and how it avoids duplicating cost already counted elsewhere.
Medical capability degrades with distance from the point of wounding to definitive care, so the program layers capability by echelon rather than issuing one kit size to everyone: the individual IFAK treats the operator’s own hemorrhage in the first minute, the team bag brings a broader capability to the scene within the detail’s own movement, the vehicle kit sustains a multi-casualty event during transit when off-vehicle resupply is not available, and the residence/static kit provides the deepest on-hand capability where evacuation time to definitive care is longest. Kit contents are bounded, at every echelon, by the certified scope of practice the operator holds under EP-029; the program does not stage capability an operator is not certified to use. SYS-009 already prices and selects the individual IFAK (REQ-SYS-009-02) and SYS-010 already prices and selects the vehicle trauma kit (REQ-SYS-010-04); this cell states the program-wide medical requirements those components must meet, cross-references them by component rather than re-pricing them, and carries the priced bill of materials for the team bag and the residence/static kit, which are net-new to the cost baseline.
Assumption A1: The detail fields at least one operator (JM, assumed) certified to a scope of practice at or above the components staged in the team bag and residence kit. Risk if false: components would be staged beyond any operator’s certified scope, which REQ-SYS-012-03 exists to prevent detection of; the corrective action is to de-scope the kit to the certified level actually held, not to add capability without training. Confidence: assumed, pending EP-029 confirmation.
1.3 Needs
- NEED-SYS-012-01: Detail operators require medical capability at every echelon of movement and static posture sufficient to control point-of-wounding hemorrhage before EMS or casevac arrival.
- Source: Team Leader (RF)
- Context: The detail’s operating AOs include remote and austere terrain where EMS response routinely exceeds the trauma “golden hour.”
- NEED-SYS-012-02: Operations manager requires that kit contents never exceed the certified medical scope of practice held by the operator assigned to that echelon, to bound clinical and liability risk.
- Source: Operations Manager (BR)
- Context: Untrained or under-certified administration of advanced interventions creates clinical harm risk and firm liability exposure; scope of practice is established and tracked by EP-029.
- NEED-SYS-012-03: Systems engineer requires that medical kits cross international borders without seizure or delay at customs or airline screening.
- Source: Systems Engineer (CS)
- Context: Engagements are cross-border; sharps, tourniquets, and controlled substances receive inconsistent customs and airline carriage treatment by jurisdiction.
- NEED-SYS-012-04: The detail medic requires kit composition to adapt to the environmental hazards of the active area of operations, beyond baseline trauma coverage.
- Source: Team Leader (RF), on behalf of the detail medic (JM)
- Context: The current AO (Costa Rica, per cc01-region-packages RGN-002) spans tropical heat exposure, marine and riverine transit, and remote rural roads with extended evacuation times.
- NEED-SYS-012-05: Operations manager requires expiry and consumption tracking on every kit echelon so depleted or expired components are replenished before the next deployment.
- Source: Operations Manager (BR)
- Context: Sealed hemostatic and pharmaceutical components carry finite shelf life; an unmonitored kit degrades silently and fails at the point of need.
- NEED-SYS-012-06: Systems engineer requires that possession and carriage of prescription and controlled medical items follow a jurisdiction-specific determination rather than a single fixed program rule.
- Source: Systems Engineer (CS)
- Context: Analgesics and epinephrine, among other items, are treated as controlled or prescription substances under materially different rules across the firm’s operating jurisdictions.
1.4 Requirements
- REQ-SYS-012-01 (Traceability: NEED-SYS-012-01): Every kit echelon shall include a CoTCCC-recommended hemorrhage-control set capable of controlling arterial hemorrhage at the point of wounding [VR-SYS-012-01].
- Verification Method: Test (T)
- REQ-SYS-012-02 (Traceability: NEED-SYS-012-01): The detail medical bag shall include airway and breathing management components sufficient to treat two casualties simultaneously [VR-SYS-012-02].
- Verification Method: Inspection (I)
- REQ-SYS-012-03 (Traceability: NEED-SYS-012-02): No medical loadout component shall require administration beyond the certified scope of practice held by the operator assigned to that kit echelon, as recorded in EP-029 [VR-SYS-012-03].
- Verification Method: Inspection (I)
- REQ-SYS-012-04 (Traceability: NEED-SYS-012-04): Kit composition for each echelon shall include environmental countermeasure items selected against the engagement’s AO hazard profile (heat, marine, remote/prolonged field care) [VR-SYS-012-04].
- Verification Method: Analysis (A)
- REQ-SYS-012-05 (Traceability: NEED-SYS-012-03): Kit components classified as sharps, tourniquets, or controlled substances shall carry a documented customs and airline transport disposition before any cross-border movement of the kit [VR-SYS-012-05].
- Verification Method: Analysis (A)
- REQ-SYS-012-06 (Traceability: NEED-SYS-012-05): Each kit echelon shall undergo an expiry and completeness check on the cadence fixed by the EP-021 detail battle rhythm [VR-SYS-012-06].
- Verification Method: Inspection (I)
- REQ-SYS-012-07 (Traceability: NEED-SYS-012-06): Possession and carriage of prescription and controlled medical items in any kit echelon shall follow the jurisdiction-specific determination documented in EP-030 for the active AO [VR-SYS-012-07].
- Verification Method: Analysis (A)
- REQ-SYS-012-08 (Traceability: NEED-SYS-012-01): The detail medical bag shall be transportable by a single designated medic during a protective movement without impairing that operator’s mobility [VR-SYS-012-08].
- Verification Method: Demonstration (D)
2. Architecture As Built
Four echelons of staged capability, layered by distance from the point of wounding; the individual and vehicle echelons are components already built under SYS-009 and SYS-010 and are shown here only as cross-references.
+---------------------------------------------------------------------------+
| SYS-012 Medical Loadout Program |
| |
| Echelon 1: Individual IFAK (per operator) -- ref. SYS-009 |
| Echelon 2: Detail Medical Bag (per movement, carried by medic JM) |
| Echelon 3: Vehicle Kit (per motorcade vehicle) -- ref. SYS-010 |
| Echelon 4: Residence/Static Kit (per protected static site) |
| |
| Bound at every echelon by: EP-029 scope of practice, EP-030 carriage |
| determination, EP-021 inspection cadence. |
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3. Components and Bill of Materials
Prices are vendor list or explicitly flagged estimates as of 2026-07-05; source links and quantity roll-up in the program cost model (BIZ-013). Per the CRITICAL PRICING RULE for this cell, a line is priced only where it is a widely known, commodity-stable retail item, and even then it is flagged (est.); every other component is a GAP row naming the item with price ungrounded pending program-development grounding. The individual IFAK and vehicle trauma kit echelons are already priced and selected under SYS-009 and SYS-010; they are shown here as REFERENCE rows at $0.00 incremental cost so this cell does not double-count them in the BIZ-013 rollup.
3.1 Individual IFAK (per operator)
| Component | Spec | Vendor / Link | Qty | Unit Price | Tier | Status | Traceability |
|---|---|---|---|---|---|---|---|
| Individual IFAK | Priced and selected under SYS-009 (NAR Eagle IFAK: CAT Gen 7 tourniquet, CoTCCC hemorrhage set) | SYS-009 (cross-reference) | 1 per operator | $0.00 (priced under SYS-009; not double-counted) | startup-now | REFERENCE | REQ-SYS-012-01, REQ-SYS-012-03 |
3.2 Detail Medical Bag (team bag, carried on movements)
| Component | Spec | Vendor / Link | Qty | Unit Price | Tier | Status | Traceability |
|---|---|---|---|---|---|---|---|
| Team trauma bag / carrier | MOLLE-compatible medic pack, single-medic carry | [VENDOR] | 1 per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-02, REQ-SYS-012-08 |
| Tourniquet, bag stock | CAT Gen 7, individual unit (beyond the operator’s own IFAK-issued unit) | North American Rescue | 2 per bag | $34.95 (est.) | startup-now | SELECTED | REQ-SYS-012-01 |
| Hemostatic gauze, CoTCCC-listed | Combat gauze class | [VENDOR] | 4 per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-01 |
| Chest seal, vented, pair | Occlusive dressing, penetrating chest trauma | [VENDOR] | 2 sets per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-01 |
| Airway adjunct set | Nasopharyngeal / supraglottic, bounded to certified responder scope | [VENDOR] | 1 set per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-02, REQ-SYS-012-03 |
| Bag-valve-mask resuscitator | Scope-conditional on medic certification | [VENDOR] | 1 per bag | [PRICE] | growth | GAP | REQ-SYS-012-02, REQ-SYS-012-03 |
| IV / fluid resuscitation module | Scope-conditional; requires certification above baseline TCCC | [VENDOR] | 1 per bag | [PRICE] | growth | GAP | REQ-SYS-012-03 |
| Burn management module | Burn dressings, hydrogel | [VENDOR] | 1 set per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-01 |
| Splint set | SAM Splint class, malleable | [VENDOR] | 2 per bag | $11.00 (est.) | startup-now | SELECTED | REQ-SYS-012-02 |
| Environmental module: heat | Oral rehydration salts, evaporative cooling towel | [VENDOR] | 1 set per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-04 |
| Environmental module: marine | Waterproof case / dry-bag insert for bag contents | [VENDOR] | 1 per bag | [PRICE] | startup-now | GAP | REQ-SYS-012-04 |
| Environmental module: remote / prolonged field care | Extended wound care, protocol-directed antibiotics | [VENDOR] | 1 set per bag | [PRICE] | growth | GAP | REQ-SYS-012-04, REQ-SYS-012-07 |
| Trauma shears | Standard EMS shears | [VENDOR] | 1 per bag | $8.99 (est.) | startup-now | SELECTED | REQ-SYS-012-02 |
Startup-now estimate-flagged subtotal (the only lines currently grounded): $100.89 per bag (2x tourniquet $69.90, 2x splint $22.00, 1x shears $8.99). This is not a bag total: nine of thirteen startup-now/growth lines remain GAP, so no per-bag total can be asserted until program development grounds them; treat the bag’s true cost as unknown, not as the estimate-flagged subtotal above.
3.3 Vehicle Kit (per motorcade vehicle)
| Component | Spec | Vendor / Link | Qty | Unit Price | Tier | Status | Traceability |
|---|---|---|---|---|---|---|---|
| Vehicle trauma kit | Priced and selected under SYS-010 (NAR Patrol Vehicle Trauma Kit) | SYS-010 (cross-reference) | 1 per vehicle | $0.00 (priced under SYS-010; not double-counted) | startup-now | REFERENCE | REQ-SYS-012-01, REQ-SYS-012-04 |
| Advanced vehicle medical module | Extended hemorrhage, airway, and burn capability beyond the SYS-010 baseline, staged for prolonged-transit AOs | [VENDOR] | 1 per vehicle | [PRICE] | growth | GAP | REQ-SYS-012-04, REQ-SYS-012-06 |
3.4 Residence / Static Kit
| Component | Spec | Vendor / Link | Qty | Unit Price | Tier | Status | Traceability |
|---|---|---|---|---|---|---|---|
| Static-site trauma bag | Fixed-location bag, larger-volume than the team bag | [VENDOR] | 1 per site | [PRICE] | startup-now | GAP | REQ-SYS-012-01 |
| Automated external defibrillator | Lay-responder class AED | [VENDOR] | 1 per site | $1,500.00 (est., volatile; retail class only) | growth | GAP | REQ-SYS-012-02 |
| Oxygen administration set | Scope-conditional on certified responder level present at the site | [VENDOR] | 1 per site | [PRICE] | growth | GAP | REQ-SYS-012-02, REQ-SYS-012-03 |
| Extended burn / wound care module | Deeper stock than the team bag’s burn module, for longer on-hand duration | [VENDOR] | 1 per site | [PRICE] | startup-now | GAP | REQ-SYS-012-01 |
| Environmental module (site AO profile) | Selected against the residence’s specific hazard set | [VENDOR] | 1 per site | [PRICE] | startup-now | GAP | REQ-SYS-012-04 |
| Controlled-substance lockbox | Chain-of-custody storage for any prescription or controlled item held at the site | [VENDOR] | 1 per site | $45.00 (est.) | startup-now | SELECTED | REQ-SYS-012-05, REQ-SYS-012-07 |
Startup-now estimate-flagged subtotal: $45.00 per site (lockbox only). Four of six lines remain GAP; the AED is growth-tier and separately GAP-priced at a volatile estimate. No per-site total can be asserted until GAP lines are grounded.
4. Build and Deployment
4.1 Issue and Staging
- Issue the individual IFAK to each operator per SYS-009 handover.
- Assemble and stage the detail medical bag with the designated detail medic (JM); verify bag weight and carry configuration against REQ-SYS-012-08 before first movement.
- Mount the vehicle trauma kit per SYS-010 installation, plus any advanced vehicle medical module selected for the AO.
- Stage the residence/static kit at the protected site, including the controlled-substance lockbox where any prescription or controlled item is held.
4.2 Pre-Deployment Verification
- Confirm, for every component staged at every echelon, that the assigned operator’s certified scope of practice under EP-029 covers its use (REQ-SYS-012-03).
- Document the customs and airline transport disposition for every sharp, tourniquet, and controlled substance before the kit crosses a border (REQ-SYS-012-05).
- Confirm the jurisdiction-specific carriage determination for prescription and controlled items against EP-030 for the destination AO (REQ-SYS-012-07).
5. Hardening Baseline
Physical and procedural controls in place of the network/host controls this cell has no digital attack surface for.
- Environmental protection: Store hemostatic and pharmaceutical components in sealed, vacuum-packed or moisture-resistant containers; check hemostatic agent and heat-sensitive medication (e.g. epinephrine) expiry and storage-temperature compliance at every inspection [REQ-SYS-012-01, REQ-SYS-012-06].
- Controlled-substance custody: Store any prescription or controlled item in the tamper-evident, chain-of-custody lockbox; log every access with operator initials, date, and reason [REQ-SYS-012-05, REQ-SYS-012-07].
- Tamper evidence: Seal team bag and residence kit modules with tamper-evident tape after each inspection so unauthorized access is visible before next-use [REQ-SYS-012-06].
6. Integration Points
| Interface | Type | Direction | Contract |
|---|---|---|---|
| Medical loadout baseline | ART-medical-loadout | Produced | Priced kit composition and program-wide medical requirements (Section 1.4, Section 3), consumed by EP-030 for the AO-specific treatment protocol and carriage determination |
| Cost baseline | ART-loadout-cost-baseline | Produced | Priced startup/growth BOM (Section 3), net of components already rolled up under SYS-009/SYS-010, consumed by the BIZ-013 program cost model |
| Training currency | EP-029 (Training and Readiness Program) | Consumed | Certified scope-of-practice register bounding permissible kit components (REQ-SYS-012-03) |
| Inspection cadence | EP-021 (Detail Battle Rhythm) | Consumed | Fixed recurring cadence for the expiry/completeness check (REQ-SYS-012-06) |
| Individual IFAK component | SYS-009 (Operator Loadout Individual) | Consumed | Cross-referenced priced IFAK component (Section 3.1); not re-priced here |
| Vehicle trauma kit component | SYS-010 (Operator Loadout Vehicle) | Consumed | Cross-referenced priced vehicle trauma kit component (Section 3.3); not re-priced here |
Traceability gap: the four consumed relationships above (EP-029, EP-021, SYS-009, SYS-010) are stated narratively in this table but are not yet reflected as inputs edges in this cell’s frontmatter, which remains inputs: [] per this task’s scope restriction to the status field only. This is reported here per the quality-gate discipline rather than silently reconciled; closing it is a follow-up frontmatter/manifest edit outside this change.
7. Acceptance Tests
| Criterion | Method | Expected Result | Reference |
|---|---|---|---|
| REQ-SYS-012-01 | Test | Hemorrhage-control set at each echelon controls a simulated arterial bleed per CoTCCC evaluation criteria | VR-SYS-012-01 |
| REQ-SYS-012-02 | Inspection | Detail medical bag manifest shows airway/breathing components sufficient for two simultaneous casualties | VR-SYS-012-02 |
| REQ-SYS-012-03 | Inspection | Every staged component’s required administration level is at or below the assigned operator’s EP-029 certified scope | VR-SYS-012-03 |
| REQ-SYS-012-04 | Analysis | Kit composition per echelon maps to the AO hazard profile (heat, marine, remote/prolonged field care) with no unaddressed hazard | VR-SYS-012-04 |
| REQ-SYS-012-05 | Analysis | Every sharp, tourniquet, and controlled-substance line carries a documented customs/airline disposition prior to cross-border movement | VR-SYS-012-05 |
| REQ-SYS-012-06 | Inspection | Expiry and completeness check completed on the EP-021 cadence with zero expired or missing components at check time | VR-SYS-012-06 |
| REQ-SYS-012-07 | Analysis | Prescription/controlled item carriage matches the EP-030 jurisdiction-specific determination for the active AO | VR-SYS-012-07 |
| REQ-SYS-012-08 | Demonstration | Designated medic carries the assembled detail medical bag through a representative movement profile without mobility impairment | VR-SYS-012-08 |
8. Run and Maintenance Handover
- Pre-Movement Check: Detail medic (JM) verifies detail medical bag contents and weight before each protective movement.
- Shift Check: Operators verify individual IFAK presence and seal integrity before each shift (executed under SYS-009; restated here as the medical-specific check).
- Battle-Rhythm Inspection: Expiry and completeness check on all four echelons executed on the cadence fixed by EP-021; findings logged and expired/depleted components replenished before the next deployment.
- Cross-Border Pre-Check: Systems engineer (CS) confirms customs/airline disposition and EP-030 carriage determination before any kit crosses a border.
- Ownership: Detail medic (JM) for team bag custody and content currency; detail operators for individual IFAK custody; Operations Manager (BR) for inspection scheduling, replenishment, and residence/vehicle kit audit; Systems Engineer (CS) for cross-border transport disposition.
Annex A: Jurisdictional and Customs Constraints
Prescription and controlled items do not carry a single fixed program rule; this annex states that explicitly rather than asserting a false uniform policy.
Prescription and controlled medical items (analgesics, epinephrine, and any scheduled substance staged in the team bag or residence kit) are subject to materially different possession, prescription, and import rules across the firm’s operating jurisdictions. This cell does not set a fixed carriage rule: possession and carriage of any such item defers to the jurisdiction-specific determination in EP-030 for the active AO, and to local law, which controls where it conflicts with any assumption in this cell or in EP-030. Sharps and tourniquets carry independent, generally more permissive but non-uniform, customs and airline screening treatment; REQ-SYS-012-05 requires a documented disposition per crossing rather than a standing assumption of transit. This annex is not legal advice; the authorization basis, jurisdiction, and disposition are to be confirmed with counsel and the destination AO’s region package before cross-border movement.
END OF SYSTEM
Model wiring
Generated from cell frontmatter at publish time.