In mining and remote areas of resource industry, there has been a development towards lacking emergency medical first aid response, that creates a potential disadvantage for patients after work accidents and other medical emergencies compared to standard population. This raises the question how a professional emergency medical coverage can be provided underground, taking into account lacking medical professionals in small resource companies combined with long rescue times. Aiming on the closure of this gap, a team of the mine rescue brigade from the Research and Training Mine Reiche Zeche (Forschungs-und Lehrbergwerk (FLB) Reiche Zeche) of the TUBAF Technische Universität Bergakademie Freiberg in Freiberg/Germany and its cooperating emergency departments of the Freiberg District Hospital and the Zeisigwaldkliniken Bethanien Chemnitz developed a totally new rescue concept using elements from tactical medicine and advanced emergency medicine combined with a specifically designed compact equipment and a highly standardised teaching curriculum. A fully new standardised and condensed tactical medical approach was developed including specifically adjusted equipment, and was taught in a didactically optimised way within 16 lessons in two days. Objective Structured Practical Examinations (OSPE) using manikins and simulated patients were conducted and compared to the identical exam of the reference group, which consisted of advanced paramedics. The standardised tactical medical scheme includes vital functions and body checks, advanced life support, nasal and intraosseous drug application, supraglottic airway management, artificial ventilation, thoracocentesis, bleeding control including tourniquet, fracture repositioning and splinting, transport bedding and thermal preservation. The developed Tactical Medical Mining Rescue (TMR) concept was subsequently included in the German guidelines for mine rescue services in 2022 and is already implemented in many companies in Germany and several international projects.