This presentation examines the theoretical foundations and practical application of improvised medicine within SAR. It will discuss improvisation as both a necessity and a disciplined practice, emphasising risk mitigation, human factors, and ethical considerations. Drawing upon operational case examples from austere and remote care environments, the session will explore practical strategies for haemorrhage control, airway adjuncts, splinting, wound management, thermoregulation, and prolonged casualty care using locally available or repurposed materials.