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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.

The destroyed exterior of the Marriott Hotel in Jakarta after the 2003 bombing

A hotel stay: reflections on the challenges managing casualties in a high-risk environment

Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 5 minutes There is nothing like a brief stay in 2020 Portland, Oregon, when it looked nearly war-torn to force you to rethink your security and tactical medical …

A CAT tourniquet, Nonin Pulse Ox, and Doppler displayed on a table

Head to head: Doppler vs. Pulse oximeter as a training tool for tourniquet efficacy. Doppler wins.

🕖 Reading Time, 5 minutes BLUF:* Is there a role for using a fingertip pulse oximeter as a training tool for tourniquet placement? We believe the answer is no. Considering the relative expense of a quality, FDA approved model pulse ox, a …

Social Media post announcing Deputy Meg Just's OSSA Lifesaving Award after taking Crisis Medicine's TC2 class

Deputy receives Lifesaver Award one month after online training and credits Crisis Medicine

🕖 Reading Time, 3 minutes When Deputy Just responded to a call regarding gunfire, she didn’t know there was a victim until she heard the 911 operator giving care instructions to bystanders. She arrived near-simultaneously with four other officers. As …