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(C) Circulation

Home - Articles - MARCH - (C) Circulation - Page 2
Showing 7-12 of 18 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. 

Two charts comparing EtCo2 levels to Venous lactate levels in trauma patients

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

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH
Mike Shertz MD/18D
November 11, 2024

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 …

Read more about Why EtCO2 Levels <35 mmHg Signal High Risk in Trauma Patients Read More
A chart showing end-tidal Co2 measured with capnometer, using an EMMA

EMMA Capnography: Enhancing EtCO2 Monitoring in Respiratory Care

  • Posted by Mike Shertz MD/18D
  • Categories (A) Airway, (C) Circulation
Mike Shertz MD/18D
October 9, 2024

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 …

Read more about EMMA Capnography: Enhancing EtCO2 Monitoring in Respiratory Care Read More
Photo showing Dial-a-Flow hooked up to both extension tubing and to IV tubing kit.

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
Mike Shertz MD/18D
April 9, 2023

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 + / – …

Read more about Is the Dial-A-Flow the most operationally useful way to manage IV infusions in a low-resource or austere setting? Read More
News article announcement about a firefighter getting shot performing CPR during the Las Vegas shooting

UPDATED: Prehospital resuscitation of traumatic cardiac arrest?

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH
Mike Shertz MD/18D
June 30, 2022

UPDATE: Is trying to resuscitate trauma patients with prehospital cardiac arrest futile? Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 8 minutes Conventional wisdom was that it was futile because the expectation of survival was too …

Read more about UPDATED: Prehospital resuscitation of traumatic cardiac arrest? Read More
A hand with dark red fingernail polish

Capillary Refill Time: Theoretical but not sound

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH
Mike Shertz MD/18D
April 17, 2022

🕖 Reading Time, 6 minutes BLUF: “Normal” values vary by age, gender, temperature (both environmental and casualty’s), and lighting conditions. Different providers will see different durations of refill time. With all these adjustments and limitations of how normal is defined, …

Read more about Capillary Refill Time: Theoretical but not sound Read More

Diversifying your options: Distal femur IO access

  • Posted by Mike Shertz MD/18D
  • Categories (C) Circulation, MARCH
Mike Shertz MD/18D
March 15, 2022

🕖 Reading Time, 3 minutes Typically, intra-osseous access is performed either in the proximal humerus or proximal tibia in the civilian setting and sternally in the military. A recent study of 2016 US prehospital IO placements in adult out-of-hospital cardiac …

Read more about Diversifying your options: Distal femur IO access Read More
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