Maybe it's obvious, but having investigate deeper things are not easy ... I would appreciate to get feedback on: what traum scheme you have been teached which you find useful / pratical 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: ABCDE 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) 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!
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!
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.
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).
It looks like (modified) ABCDE still leads ... @RogerStenning Can you share why it is surprising and not?
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!
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.
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.
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.
As I'm volunteering for a local emergency service I've been ("converted" from MARCH) trained on the 3S-F-C-ABCDE schema: Scene Safety Situation First impression Control catastrophic bleeding Airway Breathing Circulation Disability Exposure Especially the 3S are very important to personal protection and provide a valid report to 911 about what & how many other emergency services are required on scene.
Wow….first: your making this way to complicated….second: Russ is correct up-top there in his post….depends on the scenario your in…
Military medic with 1 combat deployment in Afghanistan. originally ( before my deployments I was taught ABCDE(CABCDE). Now i use MARCHE with a couple more acronyms added in there. And have been using it since 2010.
ABCDE is an acronym used in emergency medicine to help recall necessary steps of evaluating and managing a patient in the ED Airway: can the patient physically get air in the lungs? If not, may need to place a tube Breathing: is the patient spontaneously breathing? Mechanical assistance may be required. Consultation: who can I get involved in this mess? A person with deeper knowledge of medicine is needed Disposition: how can I get this person out of the ED? Once the patient has left, it's someone else's problem Elation: celebrate passing the buck to a person who can actually see this through. Acknowledge that you are ten minutes closer to going home shared with me by a retiring ED physician
@FiaOlleDog I apologize for taking so long to answer your question M A R STOP C H+H E: MPHAATD the MAR is as per normal,S- Situational awareness, T- Triage, O- Ongoing Documentation, P- pass on information ( 9 liner/Mist), C is normal, H+H- head and Hypothermia prevention, E in the everything else is M-Monitoring, P-Pain management, H-Head to to exam, A-Address all wounds, A-Antibiotics, T-Tactical scab prep, D- Documentation
