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(M) Massive Hemorrhage

Home - Articles - MARCH - (M) Massive Hemorrhage
Showing 1-6 of 41 results

Massive hemorrhage is the leading cause of preventable death from injuries.

How much blood loss is too much?

In December 1970, the US military published data on 7,800 soldier and Marine casualties from the conflict in Vietnam. In that data, specifically 10% of combat fatalities were from extremity hemorrhage. This dataset would later form the first TCCC guidelines in 1996. With the widespread adoption of tourniquets by the US. Military in the early 21st Century, death from massive extremity hemorrhage is now unusual in combat. This improvement has lead to greater awareness of massive hemorrhage from “junctional areas” like the neck, axilla/armpit, and groin, areas not amenable to circumferential tourniquet placement. To be facile at controlling massive hemorrhage, wound packing is a needed but often neglected skill set.

An X-ray showing a femur fracture

Do Femur Fractures Really Cause 1-2 Liters of Blood Loss?

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, Everything Else, MARCH
Mike Shertz MD/18D
September 8, 2026

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 2 minutes We posted recently asking the question whether traction splints are worth the weight and cube. One question that came up repeatedly was: Is the dogma correct …

Read more about Do Femur Fractures Really Cause 1-2 Liters of Blood Loss? Read More
Three photographs showing tourniquets applied to lower extremity wounds, tw of which were not medically necessary

Tourniquets in the Sahel: What a New Study Reveals About Preventable Amputations

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, MARCH
Mike Shertz MD/18D
August 17, 2026

Only 5.3% of tourniquets placed by national military forces in Burkina Faso were both medically necessary and appropriately placed. 50% of all their amputations were a byproduct of unnecessary tourniquets. Researched and written by Mike Shertz, MD/18D, not AI 🕖 …

Read more about Tourniquets in the Sahel: What a New Study Reveals About Preventable Amputations Read More
Israeli study 24% tqt complication rate

Tourniquet Complications: When a Catchy Title Doesn’t Tell the Whole Story

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, MARCH
Mike Shertz MD/18D
August 3, 2026

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 5 minutes A retrospective study at Israel’s largest Level 1 trauma center reviewed 84 adult casualties who received prehospital tourniquets between 2010 and 2020. The goal: identify tourniquet-related …

Read more about Tourniquet Complications: When a Catchy Title Doesn’t Tell the Whole Story Read More
A cartoonized version of the newly marketed SEAL spray, appearing to have been drawn in crayon

Evaluation of SEAL Hemostatic Spray: Marketing Claims vs. Published Data

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, MARCH
Mike Shertz MD/18D
September 26, 2025

Recently, both a Special Forces Medic and a civilian fire paramedic asked me about a new hemostatic product being actively marketed on social media: SEAL Hemostatic Wound Spray. Like many things on social media, you have to check the veracity: …

Read more about Evaluation of SEAL Hemostatic Spray: Marketing Claims vs. Published Data Read More
A security video still showing a lobby with desks covered with spurting blood and a clear trail of blood leading to a suspect about to die from blood loss by the revolving door

Brazilian Bank Robbery: Lethality of penetrating neck wounds

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, MARCH
Mike Shertz MD/18D
September 20, 2025

Fatal Penetrating Neck Wounds 🕖 Reading Time, 4 minutes Originally published Feb 25, 2023, but updated based on recent events and questions from students.  This video of an attempted bank robbery in Brazil shows that some injuries are just too …

Read more about Brazilian Bank Robbery: Lethality of penetrating neck wounds Read More
Dr. Shertz demonstrating good clamshell direct pressure technique: fingers interlaced, hands around the extremity to apply white-knuckle hard pressure

Clamshell Direct Pressure

  • Posted by Mike Shertz MD/18D
  • Categories (M) Massive Hemorrhage, Improvised
Mike Shertz MD/18D
August 28, 2025

A Simple, Hands-On Hemorrhage Control Technique When Tourniquets Aren’t Available Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 5 minutes In our race to use tourniquets for controlling hemorrhage, we often lose sight of the value …

Read more about Clamshell Direct Pressure Read More
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