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Which Trauma Scheme (ABCDE, MARCH, ...) have you been teached / used?

Discussion in 'First Aid Station' started by FiaOlleDog, Apr 26, 2020.

?

Trauma scheme you find most useful?

  1. ABCDE

    77.8%
  2. MARCH

    11.1%
  3. other

    11.1%
  1. FiaOlleDog

    FiaOlleDog Loaded Pockets

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    Maybe it's obvious, but having investigate deeper things are not easy ...

    I would appreciate to get feedback on:
    1. what traum scheme you have been teached
    2. which you find useful / pratical
    3. which you used already and what are your leason learned

    Some useful links:
    https://en.wikipedia.org/wiki/Tactical_combat_casualty_care#Tactical_Field_Care_(TFC)
    https://en.wikipedia.org/wiki/ABC_(medicine)
    https://firstcareprovider.org/race and https://firstcareprovider.org/poster

    To start:
    1. ABCDE
    2. MARCH, reason: getting air into the body ("AB" is useless if the casualty bleeds to death; someone can survive a couple of minutes without fresh air but major bleeding may end a life within 30 seconds)
    3. FCP's CARE, leason learned: need much more realistic training to do this automatically without need to think what's the next step

    Appreciating your reports from the field - thanks!
     
  2. ffmedic245

    ffmedic245 Loaded Pockets

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    I was taught ABCDE way back but I am aware of MARCH, just haven't encountered it thus far.
     
  3. PragmaticMurphyist

    PragmaticMurphyist Loaded Pockets

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    DR CABC (Danger, Response, Catastrophic haemorrhage, Airway, Breathing, Circulation)
     
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  4. Russ Prechtl

    Russ Prechtl EDC Junkie!!!!!

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    Active paramedic and trauma instructor here with 35+ years experience. I use ABCDE with modifications every day when taking care of people. The trick is to change it based on the needs of the situation. You are supposed to change it to "CABDE" when life-threatening hemorrhage or cardiac arrest is present. To your point, you don't worry about A and B first when heavy bleeding is present or if no blood is circulating. Otherwise, you use ABCDE.

    That's why getting training is so critical. People can't just follow an acronym blindly for best results. You have to know how to adjust based on the needs of the patient. There are no cookbook situations!
     
  5. ffmedic245

    ffmedic245 Loaded Pockets

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    ^^^this.

    Paramedic since 2003 and Stop the Bleed instructor here.
     
  6. volvoboy

    volvoboy Loaded Pockets

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    I was an EMT 40 years ago and just completed an EMT class this past month. We were taught what @RussPrecthi said. That is what I use. I am going to take the Tactical Civilian Casualty Care class in August if we are back to face2face training and I know that they teach the MARCH framework.
     
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  7. RogerStenning

    RogerStenning EDC Junkie

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    I trained ABCDE in civilian first aid courses back in the 80s, joined the reserves (the Territorial Army as was, not the Army reserve) in the 90s where it was also taught (with variation for traumatic injuries, mostly battlefield related, this before MARCH became an international thing), and back to civilian courses, where it was once again ABCDE. Even in the professional courses I've taken (HSE at Work), it's ABCDE, and not MARCH, which is surprising in some ways, and in others, not so much).
     
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  8. FiaOlleDog

    FiaOlleDog Loaded Pockets

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    It looks like (modified) ABCDE still leads ...

    @RogerStenning Can you share why it is surprising and not?
     
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  9. RogerStenning

    RogerStenning EDC Junkie

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    It's surprising that they have failed to move with a system for clearing casualties and preserving life that's been proven on the battlefield and in mass-casualty events, but not surprising, because the H&SAW doctrine does not address mass casualty events, only single casualty incidents in the workplace, despite there having been notable mass casualty events on workplaces in recent years (particularly terrorist events where first aiders would be expected to use their training to save life, regardless of a victims employment status). Like I said, surprising, and yet not.

    And yes, modified ABCDE is what I use, effectively M/AB(C)DE, although that's a bit of a mouthful!
     
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  10. Burncycle

    Burncycle Loaded Pockets

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    Personally I think ABCDE (with the caveats that Russ went into) is still a very good baseline for most situations. It's simple to remember for the layperson and first responder who may not primarily do medical calls and are already trying to remember OPQRST, SAMPLE, GCS, and so on while adrenaline is going.
     
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  11. Outbound

    Outbound Loaded Pockets

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    Emergency Medical Responder here. I agree with the above.
     
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  12. FiaOlleDog

    FiaOlleDog Loaded Pockets

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    Thanks for all the answers and insights - especially from those emergency medical staff that deals often (daily) with this.

    Maybe it's only me, but MARCH is something I can remember much better than the many variations of ABC:
    • ABC
    • ABCD
    • ABCDE
    • ABCDEF
    • ABCDEFG
    • AcBC
    • CABC
    • DR ABC
    • DRsABC
    • DRSABCD
    As stated before the most important stuff is skills, frequently training, and agility (to adopt to the situation), followed by equipment/gear.
     
    Last edited by FiaOlleDog, May 18, 2020
    #12 FiaOlleDog, May 18, 2020
    Last edited: May 18, 2020
  13. Outbound

    Outbound Loaded Pockets

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    That pretty much nails it. Under high stress in emergency situations, people almost never "rise to the occasion", they fall to the lowest level of their training. I've found medical skills to actually be quite perishable. I'm in and out of the first response stuff, and I discovered that if I don't keep up on my skills the quickly stagnate. I've had to make a point to take extra courses, or at minimum do some reading and practice drills (my wife just looooooves being the patient LOL). I'm fortunate too that my certifying body requires me to maintain "continuing competency" so I get courses to do.

    Even if you don't do this stuff for work or in a professional setting, taking a weekend first aid course every year is a good refresher. Bound Tree University has lots of free, online EMS related courses and is used as part of my continuing competency requirements. Can't hurt to find some on there that are within your scope of practice and do a little reading.
     
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