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.
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 …
A recent French article voiced a concern for overzealous pre-hospital tourniquet use; the data is not as supportive of their conclusions as the article makes it seem. Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 9 …
Very little has changed or improved in MCI triage in 40 years Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 12 minutes In 1986, an article was published discussing “new concepts in triage.”1 The authors identified …
Estimating burn size is not just a technical detail; it’s a critical component of effective burn management. Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 3 minutes Mis-estimation results in over or under-transfer to burn centers, …
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 …
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 …
