SGT’s Time MARCH: Airway, Breathing and Circulation
Good morning troops! Today I want to discuss the ABCs with you. I’m talking about Airway, Breathing and Circulation. Well, that’s so Operator 2010. OIF IV called and wants their Combat Lifesaver bag back! Ruck up troops, its time to MARCH forward into the future of battlefield and Tactical Combat Casualty Care (TCCC)!
Dang Sarge, the ABC’s were so easy to remember! Well patriots, soldiers, survivors, militiamen all MARCH. Grab your inksticks and notepads to take copious notes! No rucks needed for this MARCH.
M – Massive bleeding! This is bright red, spurting blood. It will kill you, quick. Control it! Arms and legs, tourniquets!! Arm pits, where your thighs meet your torso, pack it with Combat Gauze or other hemostatic agent gauze. Chest or back seal it up with chest seals (I used Hyfin chest seals extensively in the sandbox with excellent results). In short detect, direct pressure, devices (tourniquets, combat gauze), and don’t dilute (in other words don’t wash out clots with IV fluids or thin the blood). IV fluids don’t carry oxygen, what your vital organs need to function.
A – Airway. Able to maintain their own airway and breathing? Let them. If they can talk or scream guess what? They are moving air in and out. This is good. Unconscious patients may need jaw thrust maneuvers. Conscious with obstructed airways or impending obstructions may need these maneuvers or a nasopharyngeal airway.
R – Respiration. Be prepared to provide rescue breathing for the patient.
C – Circulation. This refers to shock. Lay the patient flat, maintain body temperature.
H – Head injury, hypothermia and helicopter. Treat any head injuries by dressing and bandaging, same with eye injuries. Remove wet gear and uniforms. Even sweaty clothing in the desert can cause hypothermia. Use a reflective rescue blanket. Evacuate the patient to a higher level of care using the most expedient means necessary. Pickup truck bed, life flight, donkey cart.
Troops listen up! THIS IS IN NO WAY A SUBSTITUTE FOR ADEQUATE TRAINING BY PROFESSIONAL TRAUMA CARE INSTRUCTORS! I AM NOT A PHYSICIAN NOR DO I INSTRUCT ANYMORE.
I STRONGLY URGE YOU TO TAKE “STOP THE BLEED” CLASSES AND A TCCC COURSE. DO NOT ATTEMPT MEASURES YOU AREN’T TRAINED TO DO.