Medicine in the drone age: prehospital emergency care under the threat of enemy UAS

The Ukraine–Russia conflict has seen unprecedented use of uncrewed aircraft system (UAS), leading to significant changes in injury patterns and medical evacuation constraints. This article examines the mechanisms of injury caused by UAS, the epidemiology of these injuries and the challenges faced by medical teams in evacuating and treating casualties. The prevalence of UAS has resulted in a higher incidence of head, neck and acoustic injuries, necessitating minimally invasive surgeries and advanced imaging techniques. The ability of Russian forces to sustain long-range UAS operations has severely restricted casualty movement and increased the risk to medical providers. This article highlights the need for enhanced force protection measures, including the use of counter-UAS technology, improved personal protective equipment and innovative evacuation strategies such as uncrewed ground vehicles. The findings underscore the importance of adapting medical practices to the evolving threat landscape and ensuring the safety and effectiveness of medical teams operating in high-risk environments.