Background: In besieged urban settings, civilian traumatic brain injury (TBI) surges while CT, theatre access, blood products and bandwidth collapse. Early neuroprotective actions and clear referral messages are frequently delayed by chaos, power loss and inexperienced teams.

Methods: Using an education-design approach, we can compress ATLS/major-incident principles and frontline neurosurgical priorities into a single workflow, stress-tested in tabletop mass-casualty drills with novice responders. Pre-specified feasibility targets were: teach time ≤20 minutes; run with blackout-tolerant kit; and assessment via a 12-item critical-actions checklist.

The SIEGE-TBI bundle contains five deployables:

1. Triage matrix (penetrating/blunt × GCS strata) with immediate life-threat red flags.
2. Neuroprotect pack with explicit targets: SpO₂ >94%; SBP ≥110 mmHg; EtCO₂ 35–40 mmHg; head-up; normothermia; glucose control; anticonvulsant triggers.
3. No-CT pathway to decide treat-and-transfer vs hold-and-observe when scanners/staff are unavailable.
4.  Tele-brief encoding GCS, pupils, lateralising signs, vitals and time-stamped actions for SMS/radio when data fail.
5. Blackout pack: headlamp checklist card, paper timestamp strip, pulse-ox and manual BP workflow, reusable for repeated strikes.

Conclusions: SIEGE-TBI offers a pragmatic, teach-today protocol for neurosurgical damage-control and escalation in the trenches.

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