M — MASSIVE HEMORRHAGE
01. Apply tourniquet 2-3" above wound, high and tight
02. Tighten until distal pulse eliminated
03. Mark time of application on tourniquet
04. Pack wound with hemostatic gauze
05. Apply direct pressure for 3 minutes minimum
TQ TIMER
00:00:00
STANDBY
A — AIRWAY
01. Check for obstruction, remove visible debris
02. Conscious: allow to assume position of comfort
03. Unconscious: head-tilt chin-lift or jaw thrust
04. Insert NPA (28Fr) with lubricant
05. If failed: surgical cricothyrotomy
R — RESPIRATION
01. Expose chest, inspect for wounds
02. Seal open chest wounds with vented chest seal
03. Monitor for tension pneumothorax
04. Needle decompression: 2nd ICS midclavicular
05. Reassess breathing after each intervention
C — CIRCULATION
01. Assess for signs of shock (altered mental status, weak pulse)
02. Establish IV/IO access
03. TXA 1g IV over 10 minutes (within 3hrs of injury)
04. Administer fluids per hemorrhagic shock protocol
05. Reassess distal pulses
H — HYPOTHERMIA / HEAD
01. Prevent hypothermia: remove wet clothing
02. Apply hypothermia prevention kit / blanket
03. Assess pupils and mental status (AVPU)
04. Elevate head 30 degrees if spinal injury not suspected
05. Monitor for changes in consciousness