MARCH
This technique is used to rapidly check for massive hemorrhage during the "M" phase by running hands firmly over the casualty's body.
What is a blood sweep (or rapid trauma assessment)?
The "P" in the PAWS algorithm stands for this, which must be carefully balanced with the casualty's tactical and physiological status.
What is Pain Management?
This type of basic airway adjunct is preferred for an unconscious casualty who does not have a gag reflex.
What is a Nasopharyngeal Airway (NPA)?
If a provider is unable to establish an Intravenous (IV) line after two attempts, TCCC dictates an immediate transition to this route of administration.
What is Intraosseous (IO) access?
The tatoo on my left shoulder.
What is Simba?
If a casualty has an altered mental status during the "H" phase, you should immediately disarm them and assess for this condition, often associated with blasts.
What is a Traumatic Brain Injury (TBI)?
For casualties with mild to moderate pain who are still able to fight, this standard-issue oral medication from the Combat Wound Medication Pack (CWMP) is preferred.
What is Mobic (Meloxicam) and Tylenol (Acetaminophen)?
This crucial intervention prevents a casualty's core body temperature from dropping, which can otherwise worsen the "lethal triad" of trauma.
What is hypothermia prevention?
When administering cold stored blood or IV fluids in a tactical environment, this type of in-line device is critical to prevent exacerbating the lethal triad.
What is a fluid warmer (or blood warmer)?
The sport I was playing when I dislocated my finger.
What is Basketball?
After completing the primary MARCH sequence, the provider moves on to the PAWS sequence, where the "P" stands for this.
What is Pain management?
For severe pain where the casualty is NOT in shock or respiratory distress, this rapid-acting intranasal or oral-transmucosal opioid is a primary TCCC option.
What is Fentanyl (Fentanyl lozenge/lollipop)?
This FDA-approved hemostatic dressing is the TCCC-recommended first choice for compressible hemorrhage not amenable to a tourniquet.
What is Combat Gauze?
When looking for a vein to start an IV on an injured arm, you should always start looking in this bend of the elbow.
What is the antecubital fossa (or AC space)?
This is the Battalion SGT Germain came to CMED from.
What is 1-124?
This is the specific preferred resuscitation fluid and ratio configuration for a casualty in hemorrhagic shock when whole blood is unavailable.
What is 1:1:1 plasma, red blood cells, and platelets (or reconstituted freeze-dried plasma)?
When managing abdominal wounds during the "W" phase, you must never attempt to do this to exposed internal organs (eviscerations).
What is push them back in?
In trauma physiology, this critical condition occurs when hypothermia, acidosis, and coagulopathy mutually reinforce each other, creating a self-limiting loop that drastically increases mortality.
What is the Lethal Triad (or Trauma Triad of Death)?
Under current TCCC guidelines, these traditional clear IV fluids (like Normal Saline and Lactated Ringer's) are generally NOT recommended for hemorrhagic shock because they do not carry oxygen or clotting factors.
What are crystalloids?
SGT Germain's favorite job.
What is Firefighter?
Under current TCCC guidelines, this clinical finding is the primary trigger for performing an immediate needle chest decompression in a casualty with a torso injury and progressive respiratory distress.
What is a suspected tension pneumothorax with signs of shock (or worsening hypoxia)?
For casualties unable to take oral medication, this injectable broad-spectrum antibiotic is administered intravenously or intramuscularly.
What is Ertapenem?
To be most effective, Tranexamic Acid (TXA) should ideally be administered within this time frame after the injury.
What is 3 hours?
This vital mineral, essential for the clotting cascade, should be administered intravenously (typically 1 gram) to casualties receiving massive blood transfusions to prevent a specific type of toxicity.
What is Calcium (Calcium Gluconate or Calcium Chloride)?
SGT Germain's kids names.
What is Arlo, Gideon, Yana, and Oliver?