Frag Out! Magazine

wounded examInatIon as a part of a rIddle: how and who Is wounded?, how you can help? what you have to Implement? one of the most important examination procedures in combat environment is a detailed trauma examination. MARCHe Protocol is noteworthy. It is based on tactical environment wounds epidemiological data, directing medic to examine particular parameters. MARCHE PRotoCol MARCHE PRotoCol Massive bleeding Stop bleeding with a tourniquet. Airway Secure patent airway through Oropharyngeal tube, epiglottis systems, intubation or cricothyrotomy. Respiratory management Secure chest wounds with seal bandage or valve bandage dedicated for TCCC. Conducting "lung sting" when breath failure. Circulation B I F T • Bleeding control • IV/IO • Fluid resuscitation • Tourniquet removal Additional examination to find bleeding source. Secure at least one intravenous / intraosseous puncture. Beginning of liquid resuscitation after pulse atrophy in arteries. Recommended liquid is Hextend 500 ml and eventually additional 500 ml after next 20 min. Changing tourniquets for hemostatic bandages (filling the wound). Hypothermia Secure wounded against heat lost. Providing active body heating procedures. Head injury Identify craniocerebral trauma. Providing neurological examination to determine TBI – "Traumatic Brain Injury". Eye injury Eyeballs falling Everything else (M – PHAAT - D) • Monitoring • Pain • Head to toe • Address all wounds • Antibiotics • Tactical Evacuation Preparation • Documentation of care Parameters assessment based on available sources (pulse oximeter, cardio monitor in the medical evacuation vehicles, blood pressure). Analgesic issues (morphine, Fentazyl sucker, ketamine) Detailed examination from head to toe, after wounded undressing. Providing antibiotic at the pre-hospital care level. Preparing to medical / tactical evacuation Documentation of care www.fragoutmag.com

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