First Aid & Trauma

MARCH: Massive hemorrhage → Airway → Respirations → Circulation → Hypothermia / Head injury. Stop the preventable death first.

Scene and ABCs Scene safety first. Then Airway, Breathing, Circulation. Control massive bleeding before a detailed secondary survey. A talking patient has a patent airway and is breathing.

Bleeding control Direct pressure with both hands. Limb: tourniquet high and tight 2–3 in above wound, not over joint; note time. Junctional (groin, axilla, neck): pack with gauze/hemostatic and continuous pressure. Do not remove packing once placed.

Fractures and sprains Immobilize in position found. Splint joint above and below. Check distal pulse/motor/sensory before and after. Open fracture: cover, do not push bone back. Simple sprain: RICE once serious injury ruled out.

Burns Cool clean room-temp water 10–20 min. Loose non-adherent cover. No ice, butter, toothpaste, grease. Facial/neck burns: watch airway. Rule of nines or palm = 1%.

Shock Warm, reassure, control bleed, elevate legs if no head/chest/pelvic injury. No oral fluids if surgery likely or unconscious. Evacuate early.

Hypothermia Out of wind/wet. Strip wet clothes, insulate from ground, warm core first. Handle gently. No alcohol. Warm sweet drinks only if fully conscious.

Heat injury Shade, loosen clothes, cool with water + fan. Heat exhaustion: cool fluids if conscious. Heat stroke (altered mental status): aggressive cooling + evacuation.

Airway & breathing Head-tilt chin-lift or jaw thrust if trauma. Clear obstruction. CPR per training. Chest seals for open chest wounds; watch for tension pneumothorax.