Discrete-Event Simulation of Contested Casualty Evacuation from the Frontlines in Ukraine

A scenario of casualty evacuations from the frontlines in Ukraine was simulated in SIMEDIS, incorporating persistent drone threats that restricted daytime evacuations. A stochastic discrete-event approach modeled casualty location and health progression. Casualties from a First-Person View drone explosion in a trench were simulated, incorporating controlled versus uncontrolled bleeding in rescue and stabilization efforts. Two evacuation strategies were compared: (A) transport to a nearby underground hospital with delays and (B) direct transport to a large hospital with potential targeting en route. Results showed that strategy A was safer for transport, but effective hemorrhage control was crucial for survival. Strategy A led to lower mortality than strategy B only when hemorrhage control was sufficient. Without it, both strategies resulted in similar mortality, emphasizing that blood loss was the primary cause of death in this simulation.