Very little has changed or improved in MCI triage in 40 years 🕖 Reading Time, 12 minutes In 1986, an article was published discussing “new concepts in triage.”1 The authors identified three areas of concern: Difficulties performing triage at an …
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.
Estimating burn size is not just a technical detail; it’s a critical component of effective burn management. Mis-estimation results in over or under-transfer to burn centers, inappropriate patient treatment, unnecessary healthcare costs, and miscalculations of IV fluid volume needed for …
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
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 carbon dioxide level, a marker of ventilation. Among changes in the 25 JAN 2024 …
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. 🕖 Reading Time, 4 minutes Traumatic brain injuries …
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 …