SIA CP Medical First Aid for Close Protection 2 — Questions and Answers
Question 1: What is 'MARCH' as a tactical first aid framework?
- Massive haemorrhage, Airway, Respiration, Circulation, Hypothermia — a tactical casualty care sequence (Correct answer)
- Movement, Arrest, Rescue, Casualty handling, Hospitalisation
- Medical Assessment, Response, Casualty, Help
- Monitor, Assess, Resuscitate, Call, Handover
Correct answer: Massive haemorrhage, Airway, Respiration, Circulation, Hypothermia — a tactical casualty care sequence
MARCH is used in tactical medicine: Massive haemorrhage control first (as it kills fastest), then Airway, Respiration, Circulation and Hypothermia prevention — overriding the traditional ABCDE sequence.
Question 2: Why does the MARCH protocol prioritise massive haemorrhage over airway?
- In traumatic injury scenarios, catastrophic bleeding kills faster than airway obstruction and is more immediately preventable (Correct answer)
- Airway problems are rare in trauma
- Airway management requires specialist equipment not available to CPOs
- The MARCH protocol is only for military use; CPOs should use ABCDE
Correct answer: In traumatic injury scenarios, catastrophic bleeding kills faster than airway obstruction and is more immediately preventable
Research from combat medicine showed that most preventable deaths in trauma were from haemorrhage; addressing bleeding immediately — before airway — saves the most lives in traumatic injury scenarios.
Question 3: What is the treatment for tension pneumothorax in a tactical first aid context?
- Needle chest decompression to relieve pressure on the lung (Correct answer)
- Direct pressure to the chest wound
- Encouraging the casualty to breathe deeply
- Placing the casualty in the recovery position
Correct answer: Needle chest decompression to relieve pressure on the lung
Tension pneumothorax (air trapped in the chest compressing the lung and heart) is treated by needle decompression; it is a life-threatening emergency recognisable by breathing difficulty, falling blood pressure and tracheal deviation.
Question 4: What is a 'chest seal' used for in tactical first aid?
- To seal an open chest wound and prevent air from being sucked in, which would collapse the lung (Correct answer)
- To provide pressure on a rib fracture
- To stabilise a suspected spinal injury
- To cover burns on the torso
Correct answer: To seal an open chest wound and prevent air from being sucked in, which would collapse the lung
An open chest wound (sucking chest wound) allows air to enter the chest cavity, collapsing the lung; a vented chest seal allows air to escape but not enter, preventing tension pneumothorax.
Question 5: What is the correct treatment for a suspected spinal injury in a tactical context?
- Minimise movement if the scene is safe; in a tactical scenario, rapid extraction may take priority over spinal precautions if the threat requires immediate movement (Correct answer)
- Always apply full spinal immobilisation before any movement
- Carry the casualty in the seated position
- Administer pain relief before any movement
Correct answer: Minimise movement if the scene is safe; in a tactical scenario, rapid extraction may take priority over spinal precautions if the threat requires immediate movement
Traditional spinal precautions can be overridden in a tactical situation where an ongoing threat makes staying in place more dangerous than movement; the decision depends on threat versus injury risk.
Question 6: What is 'hypothermia' and why is it a risk in trauma casualties?
- Abnormally low core body temperature; blood loss and shock reduce the body's ability to maintain temperature, worsening outcomes and increasing bleeding risk (Correct answer)
- A condition only relevant in cold weather environments
- A side effect of CPR
- A risk only for elderly casualties
Correct answer: Abnormally low core body temperature; blood loss and shock reduce the body's ability to maintain temperature, worsening outcomes and increasing bleeding risk
Trauma-induced hypothermia is caused by blood loss, shock and exposure; it worsens coagulopathy (impairs blood clotting), creating a lethal triad with acidosis and coagulopathy that significantly increases mortality.
SIA CP Medical First Aid for Close Protection 2
What is 'MARCH' as a tactical first aid framework?