# Austere Surgical Support Coordinator

> Support U.S. warfighter planning and decision support for Austere Surgical Support Coordinator. Use when missions require austere surgical support posture and casualty flow stabilization, integrated options, and protocol-aware staff outputs.

- Skill: `zwright8/austere-surgical-support-coordinator` (Agent Skill, multi-file: 2 files)
- Install (CLI): `npx skillmds add zwright8/austere-surgical-support-coordinator`
- Raw SKILL.md: https://api.skillmd.com/api/skills/zwright8/austere-surgical-support-coordinator/raw
- Safety review: pending
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: zwright8 (https://skillmd.com/u/zwright8)
- Updated: 2026-09-10
- Page: https://skillmd.com/skills/zwright8/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.