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(C) Circulation

Home - Articles - MARCH - (C) Circulation
Showing 1-6 of 15 results

In our MARCH mnemonic, circulation essentially asks the question:  is this patient in shock?

The preshopsital management  of hypovolemic shock, without the ability to provide blood products is limited. Historically, there are a variety of clinical indicators and management strategies for hypovolemic shock; their accuracy and successes are highly variable. 

A chart comparing the differences between proposed mnemonics MARCH and MATCH
Mike Shertz MD/18D

Tactical Resuscitation in 2025: Rethinking MARCH for the Blood Product Era

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH

Co-TCCC considered changing the MARCH mnemonic to include resuscitation, or more specifically transfusion. Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 4 minutes In 2025, with the widespread use of blood started prehospital to resuscitate US …

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A throw down of the items necessary to turn MRE heaters into IV warmers: IV fluid, 2 MRE heaters, tape, and IV tubing coiled 7 times
Mike Shertz MD/18D

From Meal to Medical Aid: Transforming MRE Heaters into IV Fluid Warmers

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, Improvised

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 9 minutes Although the ideal fluid for resuscitation of trauma patients is blood, in most austere and tactical settings, particularly outside of military Special Operations, IV crystalloids are …

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Two charts comparing EtCo2 levels to Venous lactate levels in trauma patients
Mike Shertz MD/18D

Why EtCO2 Levels <35 mmHg Signal High Risk in Trauma Patients

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH

A growing body of literature shows EtCO2 levels closely and inversely correlate with venous lactate, a marker of anaerobic metabolism. BLUF: Operationally, if your trauma patient has an EtCO2 <35 mmHg, they have a significant risk for occult shock, a …

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A chart showing end-tidal Co2 measured with capnometer, using an EMMA
Mike Shertz MD/18D

EMMA Capnography: Enhancing EtCO2 Monitoring in Respiratory Care

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

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 5 minutes To truly understand a casualty’s respiratory status, a provider needs to know both their hemoglobin oxygen saturation, which is easily measured with pulse oximetry, and exhaled …

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Photo showing Dial-a-Flow hooked up to both extension tubing and to IV tubing kit.
Mike Shertz MD/18D

Is the Dial-A-Flow the most operationally useful way to manage IV infusions in a low-resource or austere setting?

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, Travel Medicine

BLUF: The Dial-A-Flow IV regulating device is a cheap, lightweight, and easy option for administering IV infusions when traditional IV pumps aren’t available. Although it’s accuracy to deliver the exact volume of IV fluid desired can be + / – …

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News article announcement about a firefighter getting shot performing CPR during the Las Vegas shooting
Mike Shertz MD/18D

UPDATED: Prehospital resuscitation of traumatic cardiac arrest?

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation

🕖 Reading Time, 8 minutes UPDATE: Is trying to resuscitate trauma patients with prehospital cardiac arrest futile? Conventional wisdom was that it was futile because the expectation of survival was too low. Newer research shows survival rates may be higher …

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