Background: In conflict and resource-limited settings, early neurological signs guide triage and transfer, yet formal pupillometry and dependable teleconsultation are rarely available. Most apps require connectivity and controlled lighting. The aim of this study is to develop and test PUPIL-POINT, a low-cost pack combining offline smartphone pupillometry with a structured 60-second neuro-brief for rapid escalation in the first hour after head injury.

Methods: Using human-centred design, we will build: (1) a printable calibration card and clip-on light; (2) an on-device computer-vision workflow estimating pupil size and anisocoria without internet; (3) a one-screen script capturing GCS, pupils, lateralising signs, physiologic targets (SpO₂ >94%, SBP ≥110 mmHg, EtCO₂ 35–40 mmHg) and red flags; and (4) an auto-generated neuro-brief compressible for SMS/radio. Content validity came from ATLS/WHO mapping and expert review. Feasibility endpoints were prespecified: capture time ≤60 seconds, consumables <£10, and completion of all fields by novices in simulated low-light drills.

PUPIL-POINT runs entirely offline, limits photic artefact with flash-free capture, works on low-spec phones, and outputs a standardised, time-stamped brief aligned with neurosurgical referral expectations.

Conclusions: PUPIL-POINT offers a pragmatic route to better neurotrauma triage “in the trenches,” standardising the first minute of neurological assessment and the referral message when connectivity and equipment are limited. We invite partners to pilot and co-evaluate the tool.

*Editorial Note: This article describes a study protocol. The proposed study has not yet been conducted, and therefore no data or results are included.