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 term “junctional hemorrhage” first appeared in the medical literature in December 2009. It refers to injuries and bleeding occurring at the transition zones between the extremities and the torso. Although not an extremity, the neck is generally included in …
With the increasing frequency of vehicles being used as weapons by violent extremists, and ISIS’s encouragement of its followers to rent SUVs and trucks for this purpose, it is worth reviewing the trauma literature of pedestrians injured by automobiles. (UPDATED …
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 handheld doppler ultrasound is better, …
BLUF*: For the pulse oximeter’s O2 saturation reading to be valid, the device must also be consistently identifying the patient’s pulse. If the pulse waveform or notation isn’t steady, the oxygen reading isn’t valid. Fingertip oxygen saturation monitors are small, …
BLUF:* Isolated closed femur fractures are extremely rare, the internal thigh bleeding can be substantial, but tourniquet application in these closed injuries is not likely to help. A closed femur fracture can bleed l to 1.5 liters into the thigh musculature. …
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 they provided security, she began …