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.
Burns over 20% total body surface area (TBSA) result in increased capillary permeability and intravascular fluid deficits that are most severe at 24-hours post-burn. Cardiac output decreases rapidly post-burn. With correct fluid resuscitation, cardiac output returns to normal values 12 …
Airway control remains the top priority for field treatment of burn casualties.1 Hypovolemic and distributive shock can occur in burned patients but they are usually a late consequence. An inhalational burn injury can double a casualty’s burn mortality.2 Upper …
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, the …
In this social media post, the driver shot himself accidentally in the thigh while seated in a vehicle. He was unresponsive from blood loss within four minutes. He survived after tourniquet application by responding law enforcement. Though we always prefer …
In concept, any non-elastic material wrapped circumferentially around a limb and tightened should be able to generate enough pressure to occlude arterial flow and act as a tourniquet. Although there are numerous tourniquets on the market that aren’t counterfeit (a …
A doppler ultrasound is a non-invasive device that uses high-frequency sound waves to estimate the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs. A doppler ultrasound can estimate how …