first published on December 6, 2016 by Josh
The first rule of combat medicine is to make sure you are winning the fight. Fire superiority gives you a direct advantage over your enemy, and allows you to apply pressure to him, relieving some of that pressure from your own unit. With that small amount of relief, you are then able to begin the process of combat triage and medicine.
In this video, a squad sized unit of Colombian soldiers are ambushed by FARC rebels. They pick up their suppression rates and attempt to establish fire superiority while the unit’s medic begins to analyze his patients using what we can assume is the MARCH acronym.
If you are unfamiliar with the term MARCH, or in many cases SMARCH-R, you can read about it here. It’s acronym for massive hemorrhage, airway, respiration, circulation or cardiac, head injury and hypothermia.
S – Security. Before moving to the casualty and rendering aid, one must take measures to not become a casualty themselves. If your wounded buddy is lying where he was hit, there is a good chance that moving to his location will only put you in the kill zone as well. Your team needs to maneuver, lay down suppressive fire, screen with smoke grenades, or an armored vehicle needs to block for the medic.
M – Massive Hemorrhaging. First and foremost, stop the bleeding. The quickest way to fail a casualty is to let him bleed out, which can happen in seconds. Skip all that bandage then pressure dressing escalation of treatment nonsense. Seconds count. Immediately apply a tourniquet to any rapidly bleeding appendage, and place it as high as you can on the appendage. For torso wounds, pack with gauze and apply pressure.
A – Airway. Ensure the casualty is breathing by placing your ear close to the mouth and nose while looking toward the chest, watching for the rise and fall of the chest. The casualty’s tongue or blood may be blocking the airway.
R – Respiration. A chest wound may be putting massive pressure on the lungs and not allowing the diaphragm to contract, indicating a sucking chest wound. Further treatment measures and maneuvering of the casualty will be needed to alleviate that.
C – Circulation. Measures must be taken to ensure the casualty doesn’t expire as a result of going into shock after massive blood loss. Loosen constrictive clothing i.e. boots, belt, leg holsters, body armor, etc. Elevate the casualty’s feet to assist blood flow back to the heart and to the brain.
H – Hypothermia. An often overlooked condition. Hypothermia is what happens when the body temperature drops rapidly. This can happen from blood loss and the risk increases in wet and cool conditions. Remove wet clothing and cover with a blanket or whatever dry material is available to trap escaping body heat.
R – Recovery. Different traumas may call for different recovery positions, but placing the victim on their side with a knee bent will aid in circulation and breathing. Lying the casualty on their back will greatly increase the chance of suffocation or drowning if the casualty vomits. Attempt to keep wounded appendages elevated. In the event of a sucking chest wound, the casualty will be required to lie on specific (right or left) side, depending on what side the wound is on.