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.
Manual inguinal compression of the vasculature can work to occlude distal arterial blood flow. It may not constantly occlude during the entire time the rescuer is applying pressure and might require “readjustment” of the rescuer’s compression to keep occlusion, but …
No Emergency Department is fully prepared and stocked to manage 41 trauma casualties arriving in 45 minutes following a mass casualty incident (MCI) or active violent incident (AVI) as happened at Christchurch Hospital in New Zealand in 2019. Crisis Medicine’s …
UPDATE: Is trying to resuscitate trauma patients with prehospital cardiac arrest futile? Conventional wisdom was that it was futile because the expectation of survival was too low. Newer research shows survival rates may be higher than we historically believed. However, …
BLUF: “Normal” values vary by age, gender, temperature (both environmental and casualty’s), and lighting conditions. Different providers will see different durations of refill time. With all these adjustments and limitations of how normal is defined, as well as no standard …
Typically, intra-osseous access is performed either in the proximal humerus or proximal tibia in the civilian setting and sternally in the military. A recent study of 2016 US prehospital IO placements in adult out-of-hospital cardiac arrests included 888 IOs in …
Marie and her family enjoy the traditional Christmas evening gathering including dancing and a visit from Herr Drosselmeyer. Marie and her brother receive extravagant gifts, Marie’s is an exquisitely crafted nutcracker. Suddenly, there is a sound to the south of …
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