Evacuation Considerations

The en route care approach to the combined CBRN/trauma casualty should not differ from POI through TACEVAC. The (MARCHE)2 mnemonic provides a helpful methodology for assessing and applying critical interventions during transport. The medical provider should perform regular reassessments, recheck all (MARCHE)2 interventions, and intercede where necessary; prioritizing those interventions that are life-saving. In general, physical examination capabilities are degraded during transport. These challenges are amplified in the CBRN environment when the medical provider and crew are wearing PPE. Training while in MOPP IV and practicing patient care maneuvers that may be hindered by this protective posture is paramount to successful care of the CBRN casualty.