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Articles

comparison of traditional MARCHE and MARCHE2 for CBRN exposed casulaties

MARCHE2 to manage trauma patients in a CBRN environment

  • Posted by Mike Shertz MD/18D
  • Categories MARCH, Tactical CBRN

🕖 Reading Time, 5 minutes Managing casualties in high-risk environments like active violent incidents, unstable buildings from explosion or earthquake, and houses on fire is inherently challenging. Adding the possibility of CBRN (chemical, biological, radiological, or nuclear) contamination to that …

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Unstable pelvic fractures can be highly lethal

  • Posted by Mike Shertz MD/18D
  • Categories Casualty Movement, MARCH

“Pelvic fractures are common in combat injuries and may be highly lethal. Twenty-six percent of service members who died during OIF and OEF had a pelvic fracture.” 1   This led to the TCCC committee adding pelvic binders to their guidelines …

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A green bubble showing the view of a tourniquet application under NODS

What is the literature for managing casualties with night-vision (NODs) UPDATED

  • Posted by Mike Shertz MD/18D
  • Categories Equipment, Everything Else

Managing casualties in darkness is always challenging. 🕖 Reading Time, 4 minutes Typical prehospital casualty evaluation is mainly done visually with some palpation. Blood is difficult to see in lowlight settings. This has led tactical medical providers to try various …

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a photo showing a patient with a hole in their chest with blood blowing out of the hole with each exhalation. This sucking chest wound also blows, which is a sign of not dying of tension pneumothorax

A sucking (and blowing) chest wound is the sound of not dying

  • Posted by Mike Shertz MD/18D
  • Categories (R) Respiration

Video used with permission by Andrew Dennis, DO FACS, FACOS, Cook County Trauma Burn Unit, Chicago Il 🕖 Reading Time, 6 minutes Sucking chest wounds are dramatic, but rarely life-threatening. The sound of sucking & blowing is the sound of not dying …

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Regular and super-absorbant tampons compared to two 4x4s, their rough equivalent; a roll of training combat gauze; and a roll of Kerlix Gauze.

Heavy flow is not massive hemorrhage: Tampons don’t belong in IFAKs

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, Equipment

🕖 Reading Time, 6 minutes Recently we posted a video outlining the challenges of using hemostatic granules as compared to gauze. In response, we were surprised by how many people advocated for tactical tampons to control massive hemorrhage in a …

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Granular or powdered agents fell out of favor over ten years ago as they “wash out” of actively bleeding wounds, are hard to get to the point of bleeding deep inside a wound

Hemostatic powders don’t work

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, Equipment

🕖 Reading Time, 1 minutes We recently discovered “active shooter kits” being marketed to agencies and schools containing granular hemostatic agents. Granular or powdered hemostatic agents fell out of favor over ten years ago as they “wash out” of actively …

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