Monday, January 08, 2024

EMS Mnemonics - MARCH

EMS providers should be familiar with the MARCH mnemonic, which is a systematic approach to trauma patient assessment. 

Each letter in MARCH stands for a critical aspect of assessment and treatment:

1. M - Massive Hemorrhage: Assess for life-threatening bleeding and apply direct pressure or tourniquets as necessary. 

For example, if a patient has a severe laceration with uncontrolled bleeding, immediate pressure or a tourniquet should be applied.

2. A - Airway: Ensure the patient's airway is clear and assess for any obstructions or injuries that may compromise breathing. 

For instance, if a patient is unconscious and has a suspected neck injury, manual inline stabilization should be applied while maintaining an open airway.

3. R - Respiration: Evaluate the patient's breathing and address any issues that may impair ventilation. 

For example, if a trauma patient is experiencing shallow or labored breathing, supplemental oxygen or advanced airway management may be required.

4. C - Circulation: Assess the patient's circulation and address any signs of shock or inadequate perfusion. 

If a trauma patient presents with a weak pulse, rapid heart rate, and low blood pressure, intravenous fluids or blood products may be administered to restore circulation.

5. H - Hypothermia/Hyperthermia: Monitor the patient's body temperature and implement measures to prevent or treat hypothermia or hyperthermia. 

For instance, if a trauma patient is found in a cold environment, active rewarming techniques should be initiated to prevent further heat loss.

It's important to note that there are variants of the MARCH mnemonic, such as L-MARCH, which includes the addition of "L" for Laboratory and "Lethal Triad" (coagulopathy, acidosis, and hypothermia). 

These variants emphasize the importance of laboratory testing and addressing the lethal triad in trauma patients.

Remember, the MARCH approach provides a systematic framework for trauma assessment, but its application should be tailored to the specific needs of each patient. 

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