On May 28th, I had the opportunity to teach at a local Emergency Preparation Club meeting, and I feel like the topics would be good to share with you. I am going to break them into two components, so expect this theme to carry over to next week as well. If any of you are part of an organization that would like a guest speaker, I really enjoy teaching and working in small groups. I am excited to talk to you and your organizations.
Trauma Response for the Everyday Citizen
The first topic I discussed was responding to a trauma situation. Of course, one of the members asked right away if they would EVER be responding to a trauma. Since my background is in the military, this was a very reasonable question. Granted the last trauma I saw use a tourniquet to save a life was an elderly gentleman who fell through a glass table. A few other scenarios that we could face in our daily life are a rolled ATV, a car accident, a chain saw accident or even a fall from a hike.
The US military has been teaching the MARCH acronym to address trauma response. The goal is specifically to prevent someone progressing to needing CPR.
Massive hemorrhage (ARTERIAL or SPURTING BLEEDING)
- Apply a tourniquet 2-3 inches above the severe injury. Personally I am a big fan of the CAT Tourniquet but be cautious of buying cheap knock offs from Amazon. These typically cost >$20.
- #1 potentially survivable cause of death at the POI is hemorrhage from a compressible wound or any life-threatening extremity bleed.
- > 90% of 4,596 combat deaths post 11 September 2001 died of hemorrhage-associated injuries.
- Move someone to a position that will allow them to breath the best, this may be leaning forward if there is facial trauma, the recovery position on their side, or evening on their back with their shoulders lifted in a sniffing position.
- In this algorithm, the military is specifically considering treating serious chest injuries by letting air escape.
- For most people, this will be moving into the CPR realm of rescue breathing. If someone has a pulse, but no respiratory effort, give a breath every 6 seconds as you await for help.
- For providers that are able to give IVs, this would be the appropriate place to start.
- If fluids are not an option for you, providing something to drink if conscious would be appropriate.
- If there is no pulse, this is when CPR would be initiated.
- If you are able to stabilize your patient, it is imperative to keep them warm. If a patient’s temperature drops below 95 degrees Fahrenheit, their body will start to struggle with clotting and other processes.
Remember, in an emergency – any decision is better than no decision. If you are the first to respond to an emergency, do your best because you are all they have. As I stated above, I enjoy teaching, and if there is a group that could benefit from Dr. Silakoski or myself doing a class, please get in touch.
Be safe out there,
M. Ryan Odom, MD