Diferencia entre revisiones de «Tactical combat casualty care»
(Text replacement - "* " to "*") |
|||
| Línea 14: | Línea 14: | ||
*MARCH acronym is used to prioritize treatment: | *MARCH acronym is used to prioritize treatment: | ||
**'''M''' - Massive hemorrhage | **'''M''' - Massive hemorrhage | ||
*** Emphasize early recognition of significant bleeding. Apply limb tourniquets high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR. | ***Emphasize early recognition of significant bleeding. Apply limb tourniquets high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR. | ||
**'''A''' - Airway | **'''A''' - Airway | ||
*** Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present. | ***Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present. | ||
**'''R''' - Respiration | **'''R''' - Respiration | ||
*** Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds. | ***Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds. | ||
**'''C''' - Circulation | **'''C''' - Circulation | ||
***Reevaluate for peripheral pulses, tourniquets that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam. | ***Reevaluate for peripheral pulses, tourniquets that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam. | ||
Revisión del 01:13 24 jul 2017
Background
- Tactical Combat Casualty Care (TCCC) is a set of evidence-based guidelines for trauma care in a tactical or combat environment.
- Developed and updated by the Committee on Tactical Combat Casualty Care (CoTCCC), a division of the US Department of Defense Joint Trauma System (JTS).
- Goal is to reduce preventable combat deaths.
- Guidelines are divided into three "phases of care".
Phases of Care
Assessment and Triage
- Rather than typical "ABC" approach to trauma assessment, TCCC prioritizes massive hemorrhage
- MARCH acronym is used to prioritize treatment:
- M - Massive hemorrhage
- Emphasize early recognition of significant bleeding. Apply limb tourniquets high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR.
- A - Airway
- Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present.
- R - Respiration
- Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds.
- C - Circulation
- Reevaluate for peripheral pulses, tourniquets that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam.
- H - Head/Hypothermia
- Evaluate for head injury, including mental status and GCS. Treat hypothermia.
- M - Massive hemorrhage