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MARCH: Massive Hemorrhage, Airway, Respiration, Circulation, Hypothermia Prevention

The easy to remember mnemonic MARCH reminds us of the priorities in treating casualties during TECC and TCCC situations. MARCH provides a framework to address immediate life threats and gives an organized approach to begin a casualty evaluation. The MARCH mnemonic is preferable to the ABCDE model because it takes into consideration the reason you need an airway and to be breathing is to circulate blood to the casualty’s brain. Recognizing that, the first step in our casualty evaluation should be to look for massive hemorrhage.

Once past massive hemorrhage, A-R-C is loosely approximated by A-B-C. H- is a reminder that a large number of traumatic casualties arrive at the emergency department or medical treatment facility hypothermic which dramatically increases their death rate.

The MARCH mnemonic can be applied to any patient, as the initial casualty evaluation usually rules out massive hemorrhage.

A chest CT image of a pediatric patient, labeling how close the internal structures are to the chest wall

Pediatric Needle Decompression: Are We Using the Right Site and Needle Length?

Researched and written by Mike Shertz, MD/18D, not AI Pediatric-specific needle decompression recommendations remain an evolving discussion 🕖 Reading Time, 4 minutes While adult guidelines for needle decompression for tension pneumothorax are well established, pediatric-specific recommendations remain an evolving discussion. …

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

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

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 …

Comparing cricothyrotomy versus endotracheal tube intubation in the IDF between 1997 to 2021

Surgical Cricothyrotomy vs. Endotracheal Intubation: A Study of Long-Term Disability Outcomes

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 2 minutes Using IDF trauma and long-term disability databases from 1997 to 2021, researchers reviewed 19 surgical cricothyrotomies performed prehospital by paramedics or MDs (using a 6 mm …