Not as a cliché — as a survival skill. In high‑stress, traumatic situations, our bodies shift into overdrive. Breathing gets fast and shallow. Heart rate spikes. Fine motor skills drop. Brain fog creeps in. And if we don’t catch it early, we lose the clarity we need to actually help someone. This is where self‑awareness becomes a lifesaving tool. When you recognize, “My breathing is out of control,” you can take it back. A simple, intentional reset — deep breath in, deep breath out — can lower your heart rate, clear your head, and get you back in the game. It doesn’t take minutes. It doesn’t require training. It takes two seconds. A two‑count pause can shift you from panic to purpose. From scattered to focused. From overwhelmed to effective. When someone’s life is on the line, your ability to control your physiology is just as important as the skills you’ve learned. Slow your breath. Reset your mind. Then get to work.

Framework: MARCH → then Secondary Injury Management 🩸 M — Massive Hemorrhage (FIRST, ALWAYS) Fractures love to bleed—especially femur, pelvis, open fractures. - Look for life-threatening bleeding - Apply: Tourniquet (high & tight if needed) Pressure dressing Wound packing if open + bleeding - Do not splint before bleeding is controlled 👉 Remember: A broken bone can kill via blood loss. 🫁 A / R — Airway & Respiration Usually intact with isolated fractures, but: - High-energy trauma = reassess - Rib fractures? Watch for: Shallow breathing Increasing pain Signs of pneumothorax 🩸 C — Circulation / Shock Fractures can cause internal bleeding. - Check: Skin (cool, pale, clammy) Mental status Radial pulse - Treat for shock: Lay flat (if safe) Keep warm Control pain if within scope 🧠 H — Hypothermia / Head Injury - Exposed patients lose heat fast - Use: Emergency blanket Jackets / vehicle heat - Head injury + fracture = higher priority 🦴 FRACTURE IDENTIFICATION Suspect a fracture if you see: - Deformity or unnatural angle - Swelling / bruising - Pain with movement - Loss of function - Bone visible = open fracture (medical emergency) ⚠️ If it looks broken, treat it as broken. 🔒 SPLINTING: THE GOLD STANDARD Rule: Immobilize the injury and the joints above and below Steps: 1. Expose the injury 2. Check CSM (Circulation, Sensation, Movement) 3. Realign only if needed to restore circulation (and trained to do so) 4. Pad generously 5. Splint & secure 6. Recheck CSM 🧠 Field-expedient splints: - Rifles (safe & unloaded) - Tourniquet windlass rods - Sticks / trekking poles - Cardboard / magazines - SAM splint = king 👑 🚫 WHAT NOT TO DO - ❌ Don’t ignore bleeding - ❌ Don’t force realignment unless circulation is compromised - ❌ Don’t leave jewelry on (swelling risk) - ❌ Don’t forget reassessment 🎯 SCENARIO (Think It Through) You respond to a vehicle vs pedestrian. Patient has: - Obvious lower leg deformity - Bleeding controlled with pressure - Complains of severe pain

You’re at a school event or family gathering. Someone falls and has an obvious arm deformity. They’re in pain, bleeding lightly, and very anxious. 👉 What are the FIRST 3 things you would do while waiting for EMS? - Drop your answers below - There’s no judgment—this is how we learn - Read others’ responses and add what you’d do differently 💡 Being prepared isn’t about being perfect—it’s about acting instead of freezing.