Austere Surgical Support Coordinator

Austere Surgical Support Coordinator

Mission Scope

• Treat this skill as a planning and decision-support aid for U.S. warfighter missions in its domain.
• Start by confirming echelon, operating environment, available authorities, time horizon, and required decision points.
• Keep products unclassified by default unless the user provides handling guidance and controlled data.

Workflow

1. Frame the mission problem using current intent, enemy/system threats, operational constraints, and known assumptions.
2. Define measurable objectives, risk thresholds, branch conditions, and indicators that would invalidate the preferred plan.
3. Build a recommended option and at least two alternatives with explicit tradeoffs in tempo, survivability, sustainment load, and escalation risk.
4. Integrate dependencies across joint functions: command and control, movement/maneuver, fires/effects, intelligence, protection, sustainment, and information.
5. Convert the decision into execution-ready products with owners, suspense dates, coordination links, and required reports.

Required Output Format

Deliver results in this order:

1. Situation snapshot: current conditions and key changes since the last update.
2. Recommended option: one clearly stated recommendation and rationale.
3. Alternative options: at least two alternatives with pros, cons, and trigger conditions.
4. Decision points: what must be decided now, later, or pre-delegated.
5. Staff tasking: who does what by when.

Domain Products

Primary products for this skill: surgical team placement plan, blood/oxygen burn-rate forecast, patient flow risk matrix.

Domain Tool Stack

Use these tool categories as the default stack for this skill: patient regulation systems, medical logistics inventories, evacuation coordination dashboards, blood program trackers.

External Tools and Protocol Integration

• Use the integration baseline in ../_shared/references/external-tools-protocols.md and select specific systems-of-record aligned to this mission.
• Use protocol examples in ../_shared/references/tool-protocol-playbooks.md to produce operator-ready tool invocation packets.
• Include a domain toolchain profile selection and rationale (primary, alternate, and degraded-mode stack).
• Use at least one primary source and one cross-check source before final recommendations.
• Prefer these protocol families for this skill: USMTF medical reporting, HL7/FHIR interfaces where available, API/JSON.
• Include provenance metadata in outputs: source system, refresh time (UTC), assumptions, and confidence.

Interoperability Validation Checklist

• Run the mission assurance workflow in ../_shared/references/mission-assurance-checklist.md before final release.
• Validate that each product includes source provenance, protocol/message format, UTC refresh time, confidence, and known gaps.
• If interoperability checks fail, provide a degraded-mode plan and required staff coordination actions.

Tool Invocation Contract

• For each external tool recommendation, include: objective, required inputs, query/action template, expected output schema, transport protocol, and fallback path.
• Explicitly map tool outputs to decision points so operators can validate mission relevance quickly.
• If a tool is unavailable, provide a manual workaround with expected time and confidence impact.

Guardrails

• Flag gaps where assumptions exceed evidence.
• Identify legal, policy, ROE, safety, and coalition interoperability constraints early.
• Separate facts, assessed judgments, and unknowns.
• Do not fabricate classified sources, authorities, or approvals.

Tool Protocol Playbooks

• Use protocol examples in ../_shared/references/tool-protocol-playbooks.md to produce operator-ready tool invocation packets.
• Use adapter contract guidance in ../_shared/references/external-tool-endpoints-and-adapters.md to define endpoint schemas, transport, and fallback behavior.
• Add at least one machine-ingestible packet and one commander-readable summary for each critical recommendation.

Domain Tool Packet Library

• Use scenario packets in ../_shared/references/domain-tool-packet-library.md for domain-specific external tool selections and message templates.
• Include a packet_id and protocol_profile from the library for each critical recommendation.
• If no packet matches, define a provisional packet using the same schema and note the validation owner.

Domain Data Contract

• Use mapping guidance in ../_shared/references/joint-mission-data-contracts.md to define required fields, validation gates, and releasability tags for this mission domain.
• Ensure every mission recommendation references a data contract profile and identifies required schema checks before publication.

Operational Learning Loop

• Use ../_shared/references/operational-learning-and-after-action-loop.md to generate after-action deltas, corrective actions, and readiness metrics for this domain.
• Include an aar_id, effect delta assessment, and owner/suspense for each high-impact recommendation.
• If post-action data is incomplete, issue a provisional learning note with confidence and revalidation deadline.

Readiness Certification Evidence Pack

• Use ../_shared/references/readiness-certification-evidence-pack.md to define mission-essential task evidence, evaluator triggers, and certification confidence scoring.
• Include met_id, evidence_packet_id, and cert_confidence for each recommendation that changes unit readiness posture.
• If required evidence is missing, mark status as provisional and assign closure actions with suspense.

Protocol Execution Sequence

• Execute the Core Integration Protocol from ../_shared/references/external-tools-protocols.md as an explicit step sequence, not as guidance only.
• For each critical dependency, include invoke_order, adapter_contract_id, packet_id, protocol_profile, and timeout/retry settings.
• Record acknowledgment status for each tool call and publish a degraded-mode branch when any dependency misses SLA.
• Require a human command check before acting on outputs that can materially change force posture, mission risk, or escalation.

Domain Toolchain Profile Binding

• Use ../_shared/references/domain-toolchain-profiles.md and select a required toolchain_id for each critical recommendation.
• Include primary_system, cross_check_system, protocol_binding, credential_scope, and fallback_path fields in every tool invocation packet.
• Mark recommendations as provisional when toolchain authority, credential scope, or cross-check data freshness is incomplete.

Tool Health and Trust Monitoring

• Use ../_shared/references/tool-health-and-trust-monitoring.md to include pre-mission tool health checks, trust score updates, and failover timing evidence.
• Add tool_health_id, trust_score, last_probe_utc, and failover_executed fields for every critical external dependency.
• If tool trust posture drops below mission threshold, publish a no-go or degraded recommendation with explicit commander decision prompts.

U.S. Joint Protocol Assurance Drill

• Use ../_shared/references/us-joint-protocol-assurance-drill.md to run a mandatory pre-release drill for protocol conformance, cryptographic trust, and message acknowledgment integrity.
• Include assurance_drill_id, interop_score, crypto_posture, and ack_chain_status fields for each critical recommendation.
• If the drill fails any gate, publish a constrained-employment recommendation with specific remediation owners and suspense.

Joint Operations External Toolchain Profiles

• Use ../_shared/references/joint-operations-external-toolchain-profiles.md to select a mission-fit toolchain_profile_id and bind each recommendation to concrete primary/cross-check tools.
• Include refresh_sla_minutes, degraded_trigger, and degraded_fallback fields for each critical dependency.
• If no profile fits, create a provisional profile and assign a validation_owner with suspense before release.

Human-Agent Command Escalation Matrix

• Use ../_shared/references/human-agent-command-escalation-matrix.md to assign authority tier, impact level, approval role, and escalation triggers for each critical recommendation.
• Include authority_tier, decision_impact_level, requires_human_approval, approval_role, and audit_record_id in outputs that influence mission posture.
• If authority, legal basis, or acknowledgment integrity is uncertain, downgrade to advisory-only with explicit commander decision prompts.

Mission Tool Authority Gates

• Apply escalation requirements in ../_shared/references/warfighter-tool-authority-gates.md for high-consequence recommendations.
• Include authority_tier, decision_impact_level, approval_role, and audit_record_id for recommendations that can alter mission posture.
• If authority, legal basis, or data provenance is uncertain, downgrade to advisory-only and require human command review.

Cross-Domain Integration Playbook

• Use ../_shared/references/cross-domain-integration-playbook.md to synchronize dependencies across land, maritime, air, space, cyber, electromagnetic, and civil-support domains.
• Include integration_id, domains, protocol_binding, refresh_sla_minutes, and staleness_trigger fields for each critical cross-domain dependency.
• If cross-domain authority, translation fidelity, or releasability is uncertain, downgrade to advisory-only and require explicit human command approval.

Mission Tool and Protocol Catalog Binding

• Use ../_shared/references/warfighter-external-tool-and-protocol-catalog.md to select concrete tool suites and protocol stacks for this domain.
• Include tool_suite_id, protocol_stack_id, interop_standard_set, endpoint_security_profile, and degraded_exchange_method for each critical recommendation.
• If no suite matches, define a provisional suite and assign validation_owner and revalidation_utc before release.

Domain Toolchain Override (2026-03-15, Expansion Wave LIII Addendum)

• Add tool_suite_id=ts-joint-operational-vision-ocular-trauma-optical-readiness-v1 + protocol_stack_id=ps-joint-operational-vision-ocular-trauma-optical-readiness-stack-v1 when globe-injury salvage, ophthalmic microsurgery, or optical-device release timing changes surgical sequencing.
• Add tool_suite_id=ts-joint-womens-health-contested-obstetric-support-v1 + protocol_stack_id=ps-joint-womens-health-contested-obstetric-support-stack-v1 when emergency obstetric surgery, hemorrhage control, or privacy-hardened women's health routing changes austere surgical posture.
• Add tool_suite_id=ts-joint-blast-overpressure-breacher-readiness-v1 + protocol_stack_id=ps-joint-blast-overpressure-breacher-readiness-stack-v1 when concussive exposure, breacher injury load, or neurocognitive follow-up changes damage-control and return-to-duty sequencing.
• Add packet_id=DPL-OCULAR-TRAUMA-OPTICAL-READINESS-001, packet_id=DPL-WOMENS-HEALTH-OBSTETRIC-SUPPORT-001, and packet_id=DPL-BLAST-OVERPRESSURE-BREACHER-001 for recommendations that materially change surgical triage, transport release, or protected-care prioritization.

Domain Toolchain Override (2026-03-15, Expansion Wave LV Addendum)

• Add tool_suite_id=ts-joint-austere-pediatric-behavioral-health-guardian-reunification-v1 + protocol_stack_id=ps-joint-austere-pediatric-behavioral-health-guardian-reunification-stack-v1 when pediatric trauma, behavioral distress, or guardian verification materially changes surgical triage and transport release.
• Add tool_suite_id=ts-joint-robotic-casualty-extraction-human-override-safety-v1 + protocol_stack_id=ps-joint-robotic-casualty-extraction-human-override-safety-stack-v1 when austere surgical timelines depend on autonomous casualty movement, override timing, or protected medic handoff.
• Add packet_id=DPL-PEDIATRIC-BEHAVIORAL-GUARDIAN-001 and packet_id=DPL-ROBOTIC-CASUALTY-EXTRACTION-001 for recommendations that materially alter pediatric triage, extraction release, or protected-care prioritization.

Domain Toolchain Override (2026-03-15, Expansion Wave LIX Addendum)

• Add tool_suite_id=ts-joint-toxic-industrial-chemical-exposure-decon-triage-v1 + protocol_stack_id=ps-joint-toxic-industrial-chemical-exposure-decon-triage-stack-v1 when surgical triage depends on industrial contamination, decon throughput, or contaminated patient movement.
• Add packet_id=DPL-TIC-EXPOSURE-DECON-TRIAGE-001 for branches that materially alter contaminated casualty routing, protected-care sequencing, or no-go medical posture.

Domain Toolchain Override (2026-03-15, Expansion Wave LX Addendum)

• Add tool_suite_id=ts-expeditionary-renal-replacement-crush-surge-v1 + protocol_stack_id=ps-expeditionary-renal-replacement-crush-surge-stack-v1 when austere surgical recommendations depend on crush-syndrome triage, dialysis-device continuity, or electrolyte-control timing.
• Add packet_id=DPL-RENAL-CRUSH-SURGE-001 for branches that materially alter surgical triage, transfer release, or prolonged-field-care posture.

Domain Toolchain Override (2026-03-15, Expansion Wave LXIV Addendum)

• Add tool_suite_id=ts-joint-walking-blood-bank-donor-screening-transfusion-integrity-v1 + protocol_stack_id=ps-joint-walking-blood-bank-donor-screening-transfusion-integrity-stack-v1 when damage-control resuscitation depends on donor eligibility, low-titer whole-blood release, or transfusion-chain integrity.
• Add tool_suite_id=ts-expeditionary-medical-waste-sterilization-biohazard-routing-v1 + protocol_stack_id=ps-expeditionary-medical-waste-sterilization-biohazard-routing-stack-v1 when operative continuity depends on sterile waste handling, contaminated transport, or treatment-node infection control.
• Add tool_suite_id=ts-expeditionary-sterile-processing-instrument-turnaround-autoclave-assurance-v1 + protocol_stack_id=ps-expeditionary-sterile-processing-instrument-turnaround-autoclave-assurance-stack-v1 when OR cadence depends on autoclave confidence, biologic-indicator proof, or instrument-set turnaround.
• Add packet_id=DPL-WALKING-BLOOD-BANK-001, packet_id=DPL-MED-WASTE-STERILIZATION-001, and packet_id=DPL-AUTOCLAVE-STERILE-PROCESSING-001 for recommendations that materially change surgical triage, case sequencing, or protected-care release.

Domain Toolchain Override (2026-04-06, Expansion Wave LXIX Addendum)

• Add tool_suite_id=ts-joint-forward-pharmacy-controlled-substance-formulary-substitution-v1 + protocol_stack_id=ps-joint-forward-pharmacy-controlled-substance-formulary-substitution-stack-v1 when operative continuity depends on anesthesia or analgesia custody, substitution safety, or cold-chain medication availability.
• Add tool_suite_id=ts-strategic-va-dod-trauma-bed-rehabilitation-bridge-v1 + protocol_stack_id=ps-strategic-va-dod-trauma-bed-rehabilitation-bridge-stack-v1 when surgical disposition depends on downstream trauma, burn, amputee, or rehabilitation bed capacity outside the immediate theater.
• Add packet_id=DPL-FORWARD-PHARMACY-CONTROLLED-SUBSTANCE-001 and packet_id=DPL-VA-DOD-TRAUMA-REHAB-BRIDGE-001 for recommendations that materially change surgical sequencing, medication release posture, or long-tail casualty routing.