BattlefieldMed Research Workbench

LSCO surgical force structure simulator

Build and audit combat casualty flow scenarios across gridded force layouts, role-of-care assets, evacuation policies, and surgical capacity constraints.

DES discrete-event simulation
30 d CFR and DOW follow-up
Audit assumptions and logs exported
Step 1

Research Workbench Overview

This tool is a local research simulator for exploring how surgical force structure, transport geometry, routing behavior, and casualty tempo interact during large-scale combat operations.

01

Build the force

Set division strength, brigades, battalion origins, echelon spacing, and role-of-care positions on a location-agnostic grid.

02

Assign medical assets

Place Role I, Role II, and Role III capabilities; assign surgeons by specialty; configure evacuation assets, windows, staging, and transfer times.

03

Shape casualty flow

Define operation phases, casualty density, asymmetric main effort, background DNBI/NBI rates, and phenotype-cohort draw behavior.

04

Choose routing policies

Run primary, alternate, bypass, or smart-routing policies using the same geometry so time penalties are calculated from the map.

05

Run and audit

Generate deterministic pilots, density sweeps, or Monte Carlo runs with exported assumptions, audit checks, casualty logs, and workbook outputs.

06

Compare outcomes

Review time to surgery, 30-day CFR, DOW rate, evacuation flow, blood demand, and cause-of-death summaries across tested strategies.

How to interpret results

The simulator is intended for research design, sensitivity analysis, and coauthor review. Results depend on the configured assumptions and should be interpreted with the exported audit workbook, source notes, and scenario settings.

Admin

User Access

Create Login

local account
Access Control
Local users
Step 2

Saved Versions

Selected Version

Built-In Version
Default Forward Surgical Teams

Select a saved or built-in version.

Scenario Version
Select a saved or built-in version
Selected Default
Source Built-In Version
Updated -

Saved Versions

your account

Built-In Versions

built-in defaults
Step 3

Force Structure

Geometry
Standard division

Division Geometry

x frontage, y rearward depth
Step 4

Medical Units & Capacity

Role II Brigade Locations

primary package by brigade

Role III Hospital Center

component modules
Medical Network
Default echelon care
Advanced Brigade Overrides per-location surgeons, OR, and holding
Advanced Role Defaults role assignment and surgeon sliders

Surgeon Work-Rest

staffing availability

Applies to surgeon calendars after case completion. This changes effective surgical availability, not casualty generation or routing.

Surgical Duration

gamma by ISS tier
Step 5

Evacuation Assets

Ground Evacuation Assets

ambulances and call time

Role I to Role II

Forward echelon evacuation leg

Role II to Role III

Rearward decompression leg

Air Evacuation

availability and forward reach
Advanced Evacuation Options movement, loading, windows

Ground Movement

Ground Launch Window

Handoff and Launch

Air Platform Details

Air Launch Window

Evacuation Network
Ground and air assets

Evacuation Network Schematic

asset totals, capacity, timing, and route access
Step 6

Operation

Density Sweep
By-Phase Controls 36 phases
Casualty Tempo
Custom phased operation

Operation Casualty Curve

combat density plus DNBI floor by day

Historic Density Calibration

source-based battle benchmarks
Step 7

Casualty Cohort Draw

Background Casualties

additive daily rate

Combat Mechanism Mix

Advanced Cohort Sampling V26 template cohort
Casualty Event Clustering
Generation Model
Current cohort draw

Current Draw Mix

active streams and mechanism weights

Cohort Diagnostics

reference priors and branch tables
Evac Signal --
Local Signal --
Surgical ISS --
Mobility --
Combat Events/Day --

Reference Priors

current cohort configuration

Pathway Branches

all-casualty shares

Surgical Demand

Hall composite ISS categories
Step 8

Blood Accounting

Forward Blood

WBB enabled

Derived donor pool

Advanced WBB Timing active caps

Forward availability accounting records source and shortfall without changing evacuation, surgery, or survival.

Advanced Demand Model cohort rows

These controls shape regenerated/live-generator blood demand. The default sampled cohort already carries WBE need on each casualty row.

WBE Tier Definitions

unit ranges

ISS Transfusion Matrix

fallback prior
Blood Accounting
WBE demand logged by casualty and location
Cohort GWOT 25k
Any Blood -
Battle WIA Blood -
WBE / Battle WIA -
Pre-Role II -
MT+ Rows -

Selected Cohort Blood Signal

row-derived demand
All Casualties Needing Blood - -
Battle WIA Needing Blood - -
Mean WBE per Battle WIA - -
Surgical Blood Rows - -

Forward Source Setup

WBB and Role I stored blood
Walking Blood Bank On
-
Stored Role I Blood Off
-
Pre-Role II Demand Tracked
-

Calibration Preview Tables

generator-only view

Cohort Demand Prior

severity-weighted accounting

Blood Tier Definitions

whole-blood-equivalent units
Step 9

Triage & Prioritization

Prehospital Clinical Triage

standard

Transport Triage

platform priority

Surgical Triage

queue order

Specialist Behaviors

assist policy
Specialty calendars and assist speed
Triage Pipeline
Clinical, transport, and surgical prioritization

Triage Decision Map

what changes patient priority

Queue and Specialist Effects

who gets scarce time first

Advanced Execution Tables

rule audit view

Casualty Flow Priority Rules

decision order

Clinical Triage Effects

observed vs true

Specialty Utilization Policy

behavior and speed
Step 10

Mortality Calibration

Advanced Rapid Fatality Gate mirrors Step 8

This mirrors rapid pre-MTF KIA on the casualty page. These casualties do not consume workload, but their cause and early timing remain visible in cohort clock audits and all-casualty survival curves.

Baseline 30-Day KM

ISS priors

Death Timing

cumulative shares

Combined DNBI KM

nonop aggregate

DNBI stays combined for now. These casualties still enter litter/ambulatory assignment and triage; they do not receive the general/trauma or neurosurgical unmet-capability penalty unless generated as a true surgical NBI case.

Advanced Delay Overlay gen/neuro unmet capability

Use the preview slider as a what-if: moving it right shows later access to needed trauma or neurosurgical care and should pull the modified survival curves downward, especially for severe and critical casualties. Actual DES runs use each casualty's simulated wait time. Early hazard is limited to the configured early window, prolonged unmet need adds capped hourly risk after the grace point, and delayed survivors can retain capped post-op debt. Isolated orthopedic-only cases do not receive this mortality penalty.

Survival Calibration
Baseline KM, phenotype clocks, and advanced delay overlay

Kaplan-Meier Preview

baseline vs preview wait
Step 11

Routing

Bypass Rules

Role III trigger
Role II Status Threshold Trigger active

Smart Routing

queue-aware

Routing Behaviors

Policy sweep

Active Setup

current controls
Step 12

STRATEVAC

Decompression Demand

Role III downstream lift
STRATEVAC Plan
Demand tracking off

STRATEVAC Lift Preview

sorties, CCATT, litter, and ambulatory capacity
Step 13

Monte Carlo

Replication Budget

1 = single DES run

Adaptive Stop Rule

admin Monte Carlo

Adaptive convergence is always evaluated independently for each scenario cell: scenario, density, routing policy, and selected comparison.

Reproducibility

seeded iterations

This seed reproduces the whole run package. Each scenario cell and iteration receives its own logged seed derived from it.

Replication Control
Single DES pilot run
Mode Single
Runs per Cell 1
Metric Mean TTS
Estimated Runs 6

Stop Rule

documented in run outputs

Monte Carlo Audit

adaptive convergence controls
Step 14

Scenario Run

Run Target Current Workbench Settings
Comparisons None

Compare Against

optional saved settings

The current workbench settings always run. Select default or saved settings only when you want a side-by-side comparison in the same output folder.

Save Scenario Template

current controls
Status
Ready
Day - / - Idle
Elapsed - Iteration -
0 / 0 cells complete Sweep waiting
Cells 0
Best Mean TTS -
Best Median TTS -
Best Combat 30-Day CFR -
Audit Status -

Key Results

TTS, 30-day CFR, and DOW rate

TTS by Density

separate panels by strategy and setting

30-Day CFR

combat casualty convention

DOW Rate

died of wounds convention

Time to Surgery Buckets

selected scenario, density, and strategy

Blood Demand

WBE by location class and density

Role II Resupply

rolling interval peak versus package

Forward Blood Sources

pre-Role II demand by source

Casualty Class Mix

generated casualty categories

Injury Pattern Mix

mechanism and broad injury type

Causes of Death

share of deaths by cause group

Potentially Survivable Deaths

share by cause among preventable context deaths

Comparison

current settings vs selected saved/default versions
Comparison views only populate when Step 14 includes one or more selected comparison versions.

Comparison TTS

current vs comparison mean TTS

Comparison CFR

current vs comparison combat 30-day CFR

Comparison Table

current vs selected comparisons
Spreadsheet preview tables

The workbook and CSV files contain the complete audit/output detail. These tables are kept here only as a quick preview.

Epidemiology Summary

generator audit outputs

Scenario Summary

all layout/profile cells