Managment of the march protocol at the stage of emergency care in emergency conditions

Abstract

Introduction. According to statistics, 90% of deaths on the battlefield occur at the pre-medical stage. However, some problems, such as bleeding from the extremities, severe pneumothorax, and airway problems, can be controlled in the prehospital setting. Of all the known protocols for these conditions, the last one used in the world today is the MARCH pre-medical protocol. The aim of the study is to assess the possibility of adapting the MARCH protocol for civilians in emergencies and hostilities. Materials and methods. A review of modern world and domestic literature on the algorithms of primary home care. Results and discussion. Three basic algorithms are used to provide primary care for the wounded: 1. The “MARCH” protocol is a sequence of actions during the provision of emergency home care to the wounded both on the battlefield and at the stage of evacuation. 2. CABCDE algorithm (Western European algorithm). 3. The Wheel-Bridge Algorithm, which is used to facilitate training in first aid for the wounded based on NATO standards. It fully reproduces the sequence of NATO’s protocol in Ukrainian only. These standards are designed for physicians who provide assistance on the battlefield, and they include stages with clear objectives, but these standards can be applied to civilians at the stage of primary care in non-life-threatening conditions, ie in places where no direct combat actions. This type of care corresponds to tactical medical care. Educating citizens in the basics of tactical medicine and implementing NATOstandard pre-medical tactical care algorithms is an important aspect of hostilities that will reduce civilian mortality and awareness of military emergencies. Conclusions. The issue of insufficient training of the population in the field of first aid in case of injuries and wounds is an urgent problem and needs to be addressed by improving the practical skills of the civilian population and by developing recommendations for a first aid kit for everyday wear. The MARCH algorithm can be easily and effortlessly adapted in Ukraine and is accessible to people without medical education, and its implementation among civilians will help improve the quality of pre-medical care and reduce mortality among the population in the area of hostilities or emergencies.