Immediate Care- M.A.R.C.H

Just wanted to do a quick breakdown of things that everyone should have one them for an IFAK, and what should be expanded to a vehicle med kit. Longer term items like antibiotics, and minor items are left to individual preference.

The military has been using the H.A.B.C acronym for a while to teach priortization of care. This stands for Hemorrhaging, Airway, Breathing, Circulation. The newer acronym, M.A.R.C.H, covers Massive hemorrhage, airway, breathing, circulation, and hyper/hypothermia. This is a bit better to focus on as it covers most life threatening conditions, minus shock, but the treatment for that can overlap with hypothermia a bit anyway.

What to have on you:
M- tourniquet, compression bandages, hemostatic agent (quickclot). Tourniquet stops bleeding from an extremity, the latter two for anything you cant tourniquet. Use this to stop squirting, massive bloodloss.

Airway- an NPA is easy. They’re cheap on many websites, and just require insertion in a nostril with some lubrication. Knowing the heimlich is a personal skill for this one, and if you have the medical expertise to perform a tracheotomy, you dont need this list anyway.

Breathing- chest seals are good to have. In the event of a penetrating wound to the upper torso, cover the entrance and exit wounds with chest seals. I have the Halo ones because this part of the kit also includes a chest decompression needle for me. You shouldnt attempt a chest decompression without training, but the basics are inserting it perpendicular to the chest between the second and third ribs, along the top of the third rib, roughly above the nipple on the side with the penetrating chest wound.

Expanded kit:

Circulation- more israeli bandages, gauze, and medical tape. I’d also recommend uncoated aspirin to help with someone who experiences a heart attack. This section is really for slower bleeds, but you might as well throw it in.

Hyper/hypothermia- hyperthermia is tricky to prepare for and is more about prevention. However, if you’re going to have a lot of people being very active on a hot day, I’d suggest having a vehicle carry a cooler with ice water and another cooler with ice covering several cotton bed sheets. For overheating, have people submerge their arms past the elbows in ice water for 30-60 seconds, then hold their arms over their head while walking around. For serious overheating, i.e heat exhaustion and stroke, take the ice sheets and pack them around the neck, armpits, and groin while covering them with another. This sucks to have done to you. For hypothermia, make sure you have multiple layers and blankets available, along with space blankets. If someone has hypothermia, get them naked and under layers, and have someone (or multiple someones) strip down and get very cozy with them to start getting their temp back up.

It goes without saying that you should always contact emergency services when possible, but this can help keep people alive when that either isnt possible, or they’re a long way away.

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Immediate Care- M.A.R.C.H