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 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 …
National and international guidelines on TBI management don’t typically specify using mannitol or hypertonic saline, because there was never good data showing one was superior to the other. That may have changed. Researched and written by Mike Shertz, MD/18D, not …
Can you use nipple location as a physical landmark for chest tube placement? Is it the same for men and women? BLUF: No. 🕖 Reading Time, 4 minutes Using the nipple as a marker for the 5th ICS as recommended …
UPDATE 2024: Since our original STAT “tourniquet” experience showing it was an ineffective device for hemorrhage control, there have been two peer-reviewed, published studies finding similar results. 🕖 Reading Time, 6 minutes Most recently, 84 volunteers with no prior tourniquet …
This set of Willis Cigarette cards from the early 20th Century demonstrated first aid techniques for use in an emergency. Some say they were meant to be stored in the “medicine chest” as part of a first aid kit.
