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  #1  
Old 17 February 2008, 16:11
MoonDog MoonDog is offline
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TCCC and MARCHES

Has the introduction of MARCH into the medical trauma mix changed the concepts of TCCC as it is applied by operators down range?
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Old 17 February 2008, 16:27
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Are you referring specifically to MARCH, or to the general concept of bleeding before airway?
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Old 17 February 2008, 16:30
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Quote:
Originally Posted by MoonDog
Has the introduction of MARCH into the medical trauma mix changed the concepts of TCCC as it is applied by operators down range?

Can someone please explain to this old dog what TCCC and MARCH mean - I did a search and saw the acronyms used several places but did not see one that explained what they mean.

Here in Fort Worth, TCCC means Tarrant County Community College - of course March is that wonderful time of the year when Basket Ball fans go Mad.

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Old 17 February 2008, 16:42
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TCCC- Tactical Combat Casualty Care


MARCH- Massive Hemmorhaging, Airway, Respiration, Circulation, Hypothermia and Head Injury


I'll let the experts explain further.
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Old 17 February 2008, 16:55
MoonDog MoonDog is offline
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General(?). Back in the day, airway was important unless there was getting ready to be an immediate shortage of blood. (Heh, if trauma 3 was easy.......)

From what I can find, it doesn't appear that it changes what gets yanked out of an aid bag first. But, I need my brothers to verify or correct PRN.

"Air goes in and out and blood goes round and round. If it ain't, fix it!"
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Old 17 February 2008, 17:22
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Quote:
Originally Posted by MoonDog
General(?). Back in the day, airway was important unless there was getting ready to be an immediate shortage of blood. (Heh, if trauma 3 was easy.......)
Exactly. Only now it is sanctioned. TCCC is now gaining a legitmiate recognition through the momentum of Pre-Hospital Trauma Life Support. So the text books, and evaluations like trauma III will eventually be forced to change. It's hapenning slowly- one of the strange evils of war. So there's the sanctioning, sort of.

The practicality of it, I suppose is that non-medics now know this without having been confused with differing standards of testing verses reality like us medics have. They get their down and dirty straight from Combat Life Saver courses and pre-deployment training under the guidelines of TCCC.

Has it changed what comes out of the aidbag first in real world? Probably not. But MORE people are doing it because 'first responder", or "rescuer" type training has expanded to all servicemembers.
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Old 17 February 2008, 17:26
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Quote:
Originally Posted by MoonDog
General(?). Back in the day, airway was important unless there was getting ready to be an immediate shortage of blood. (Heh, if trauma 3 was easy.......)

From what I can find, it doesn't appear that it changes what gets yanked out of an aid bag first. But, I need my brothers to verify or correct PRN.

"Air goes in and out and blood goes round and round. If it ain't, fix it!"



"It's basic plumbing. Keep the blood in and the air going in and out." Heard that a few times at DMOC. But yes, at least in the DMOC course, massive bleeds get priority over the airway. Key word being massive.
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Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.
In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.
Beyond this place of wrath and tears
Looms but the Horror of the shade
And yet the menace of the years
Finds, and shall find, me unafraid.
It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate
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Old 17 February 2008, 18:56
MoonDog MoonDog is offline
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You got it Sharky.

Question comes from mentoring some young medics going to the box. Another medic and I were helping conduct LTT and realized these young medics had been "flash fried" at Ft. Sam, and shipped to their parent units. (Which means they knew which side of the band aid was sticky.)

Well meaning MDs and PAs had attempted to correct this and presented didactic info full of acronyms and in depth information.

When it came time for the medics to provide care, the other medic and I realized these young medics needed to know a great deal more of what to do, and a lot less on why to do it.

So, I thought I'd check myself before I wreck myself. :D

VR,
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Old 17 February 2008, 19:31
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Sorry Moondog, for the convoluted response to a simple quetion. Glad you got your answer in spite of my leisure activity on a Sunday. :)
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Old 17 February 2008, 19:53
MoonDog MoonDog is offline
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Thanks for the info, and drive on with ur bad self. :D
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  #11  
Old 17 February 2008, 22:06
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Quote:
Originally Posted by MoonDog
When it came time for the medics to provide care, the other medic and I realized these young medics needed to know a great deal more of what to do, and a lot less on why to do it.





That was the great thing about DMOC. As a shooter, I dont really care so much about the "why", although it was covered a bit. I do care about the "what". Based on WHAT I see, I know WHAT needs to be done. The "why" was covered just enough to make the "what" make sense. When there is a lot of "what" to be done, the "why" helped to prioritize the "what".

Know what I mean? :D


Edited to add that there were some medics there who knew a lot about "why", but didn't know much more about the "what" than the rest of us. One of the senior medics was pulled aside by one of the E-8's and asked about how much he knew comparatively speaking about QuikClot before and after the course. His response was that he thought he knew what there was to know about it and found out that he really didn't know shit.
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Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.
In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.
Beyond this place of wrath and tears
Looms but the Horror of the shade
And yet the menace of the years
Finds, and shall find, me unafraid.
It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate
I am the captain of my soul.
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  #12  
Old 17 February 2008, 23:17
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Quote:
Originally Posted by Sharky
His response was that he thought he knew what there was to know about it and found out that he really didn't know shit.
Time and time again, the more I learn the more I realize how little I know. Always good and humbling.
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  #13  
Old 18 February 2008, 06:09
MoonDog MoonDog is offline
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Thumbs up

Sharky, spot on Brother.

Why is nice in the clinics and while playing trivial pursuit. Medics (like the E-8) waste a lot of time learning big words to impress the MDs and PAs (while standing around the clinic and playing tivial pursuit). I've never had a wounded troop ask me about the Kreb cycle or the nephron.

Medics get paid to reverse the dying process as close to the time of injury as possible. Anything else is eye wash and ass kissing.

Edit: Please replace Sr. Medic for E-8.
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  #14  
Old 18 February 2008, 11:45
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What Sharky said in #11 +1!

BREAK///BREAK...

Paladin...get off the couch, young'in:D

Keep The Faith...

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  #15  
Old 20 February 2008, 11:38
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I'm in a position where I would like to bring up the MARCH concept in professional discussion - but I don't think I can, 'cause I can't find any reference material. Somebody somewhere has to have published this, or you all wouldn't be having this conversation. So even though the question has been asked before, I'll ask again - Is there anything available that can be pointed to as reference? I can jack my jaw all I want with my bubba's, but if I talk to my boss, he's gonna ask...

"Slow, Noisy, and Harmless"
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Old 20 February 2008, 23:25
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Foggy. I see you are in Baltimore. Go to Shock Trauma and ask for the Air Force CSTARS guy. He will square you away.

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Damn my outside voice.
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  #17  
Old 20 February 2008, 23:48
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Foggy7,

Are you familiar with the concepts of TCCC? If not, there is plenty of info on it on the net and I would start there. Once you do that MARCH will make more sense to you since it is just an acronym used in reference to the treatment priorities of TCCC.
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  #18  
Old 21 February 2008, 13:08
foggy7 foggy7 is offline
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Paladin: WILCO, thank you, sir.

Global Med: Yes sir, thanks. I guess we actually are employing the MARCH concept even now - it is simply an acronym, as you say. I apologize if I seemed "hooked" to the acronym. That wasn't my intent. I have a personal habit of digging into language. Not a bad thing, I think; just my thing...

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  #19  
Old 9 March 2008, 19:17
009and.5 009and.5 is offline
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MoonDog, I am in SOCMSSC right now and there have been a few changes to TCCC in the last year.

One is that you don't convert a tourniquet to a pressure dressing unless the patient has a radial pulse or BP of 80. They have also done away with the trendelenburg position for hypovolemic shock. The last major change is that they recommend a three sided occlusive dressing or one with a valve instead of a four sided one.

All of the principals are the same but they are tweaking things from results of different studies.
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  #20  
Old 9 March 2008, 20:55
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foggy: The primary reference for TCCC is the Pre-Hospital Trauma Life Support manual, 6th edition.

009: Whast the ration behind doing away with trendelenburg?
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