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Efficacy of the Mnemonic Device "MARCH PAWS" as a Checklist for Pararescuemen During Tactical Field Care and Tactical Evacuation

2017; Volume: 17; Issue: 4 Linguagem: Inglês

10.55460/4r92-esfr

1553-9768

John Kosequat, Stephen Rush, Ian Simonsen, Isabelle Gallo, A. J. Scott, Kent Swats, Colby C Gray, Brock Mason,

Disaster Response and Management

Pararescuemen (PJs) access and treat injuries on and off the battlefield.The use of the mnemonic MARCH PAWS is an effective and complete tool for treating the majority of all battlefield and non-battlefield injuries.Checklists are important in aviation and ensure that procedures are carried out thoroughly and methodically.In the Air Force, organized and complete medical care is also essential on and off the battlefield.MARCH PAWS is an acronym of which each letter corresponds to the following first line diagnoses and treatment protocol terms in order of relevance: Massive h e m o r r h a g e , A i r w a y, R e s p i r a t i o n , C i r c u l a t i o n , Hypothermia/Head injury, Pain, Antibiotics, Wounds, Splints.We undertook this study to review the results of using the mnemonic MARCH PAWS and its effectiveness as a tool for accurately treating injuries, inclusive of trauma, infection, and hypothermia.In addition, treatment incorporating part of the MARCH PAWS mnemonic as well as the frequency of treatment not covered by MARCH PAWS was also observed.The use of this acronym is equivalent to a checklist approach.Mnemonics have been used since ancient Greece; however, the modern checklist has its origins in aviation.In 1935, a test pilot forgot a pre-flight step and the test flight ended in a crash shortly after takeoff.The fallibility of human memory was the culprit.Providing concise systematic instructions of all critical tasks resulted in the modern checklist.Today, checklists are an integral part of many invasive medical procedures, reducing risks and improving outcomes; substantially reducing rates of infection, errors in dosing, surgical mishaps, and many other preventable mistakes.While checklists can ensure high medical standards, applications in battlefield medicine are not practical.Alternatively, mnemonics are convenient tools that jog medic's memories under stress, but are often too narrow in scope or too generalized to be used alone.The solution combines the convenience and practicality of a traditional mnemonic and the comprehensiveness of a checklist.The first checklist-style medical mnemonic was perhaps the age-old acronym, ABC, originating in 1953.ABC was a simple way to treat cardiac arrests based on the medical knowledge of the time and was a subsequent standard for all pre-hospital providers for nearly fifty years.The acronym was changed to CAB, addressing the greatest immediate life threat, massive hemorrhage, after a groundbreaking article on TCCC published in 1996 began to challenge the concept.That change led to the creation of MARCH with the later addition of PAWS.Through MARCH PAWS, we have achieved the difficult balance between simplicity and thoroughness. Methods Conclusion