The second part of circulation management in TFC focuses on shock recognition and management, intravenous or intraosseous access, and TXA administration.

The signs and symptoms of shock, the use of peripheral pulses and level of consciousness in the determination of shock, the lethal triad of shock, and refractory shock were discussed.

Additionally, the indications for and methods of establishing both IV and IO access were identified, as well as the indications and methods of administering TXA.

The skills that were taught and practiced included placing a field-ruggedized saline lock and establishing IO access using both the FAST and EZ-IO intraosseous systems, as well as demonstrating the administration of TXA.

The next module will focus on another aspect of the circulation phase of the MARCH-PAWS sequence in the Tactical Field Care environment: hemorrhagic shock fluid resuscitation.