Patient Assessment & Casualty Management

This page provides a high-level overview of the core assessment and reporting frameworks used across emergency medicine, tactical care, and disaster response. Each section serves as a jump point to more detailed guides, job aids, and printable forms.

Why Structured Assessment Matters

Structured assessment systems exist to:

• Prioritize life-threatening problems first
• Reduce missed injuries
• Create a shared mental model among caregivers
• Enable clear handoff and documentation

These tools are modular. You do not need all of them at once — but you should know when and why to use each.

Primary & Immediate Life-Threat Assessment

MARCH-PAWS

Purpose

Identify and treat immediate causes of preventable death.

Used when

Trauma, violence, blast injuries, major accidents, or any situation with uncontrolled bleeding or airway compromise.

MARCH-PAWS comes from the TCCC Guidelines (2024).

Why it matters: MARCH-PAWS enforces a do-the-most-critical-first mindset before moving on to detailed assessment.

➡️ Jump to: MARCH-PAWS step-by-step guide

Rapid Trauma Survey

DCAP-BTLS

Purpose

Systematic head-to-toe trauma identification.

Used when

After immediate life threats are controlled.

Why it matters: DCAP-BTLS prevents fixation on obvious injuries while missing hidden ones.

➡️ Jump to: DCAP-BTLS body-region checklist

Patient History & Symptom Assessment

SAMPLE + OPQRST

Purpose

Capture medical history and clarify the patient’s complaint.

Used when

Medical emergencies, illness, or trauma once the patient is stable enough to answer questions.

Why it matters: These frameworks turn vague complaints into actionable information.

➡️ Jump to: SAMPLE + OPQRST interview guide

Mass Casualty Prioritization

START Triage

Purpose

Rapidly prioritize multiple patients when resources are limited.

Used when

Mass casualty incidents, disasters, or overwhelmed care situations.

Some agencies use SALT triage (Sort, Assess, Lifesaving interventions, Treatment/transport) instead of START, so check what your local system uses.

Why it matters: START triage accepts hard realities — it focuses resources where they will save the most lives.

➡️ Jump to: START triage flowchart & drills

Reporting & Documentation

CASREP (Casualty Report)

Purpose

Rapid situation reporting to higher authority or support elements.

Used when

Communicating patient status during disasters, tactical operations, or remote incidents.

Typical elements include:

• Location
• Number of casualties
• Severity
• Immediate needs
• Evacuation requirements

Why it matters: Clear reports prevent delays, duplication, and misallocation of resources.

➡️ Jump to: Patient Assessment – Documentation

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TCCC Card (DD Form 1380)

Purpose

Continuity of care during tactical or austere evacuation chains.

Used when

Trauma care, especially where patients may change hands.

Why it matters: The TCCC card travels with the patient and preserves critical treatment data under chaotic conditions.

➡️ Jump to: How to properly fill out a TCCC card

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Patient Care Report (PCR)

Purpose

Detailed clinical documentation of assessment, treatment, and response.

Used when

Extended care, delayed evacuation, or post-incident review.

Why it matters: PCRs support continuity of care, legal protection, training review, and after-action analysis.

➡️ Jump to: Patient Care Reports and Documentation

The Hard Decision: Stay or Move

In wilderness, disaster, or grid-down environments, evacuation is not always possible — or safe.

Factors to Consider

Key principle:

Do not create a second patient by forcing movement.

Sometimes the correct decision is to treat, stabilize, and shelter in place.

➡️ Jump to: Stay vs Move decision framework

How to Use This Material

• Use one framework at a time
• Build muscle memory
• Layer complexity as skills increase

This overview page is your map. Each linked page provides depth, drills, and printable tools.