The modified crABCDE treatment algorithm as recommendation in extreme cold.

Abstract

Trauma care prioritizes life-threatening conditions using the ABCDE algorithm based on the principle "treat first what kills first". As for catastrophic hemorrhage, a leading preventable cause of death in trauma, modifications of this algorithm are necessary in specific cases. In cold climates, life-threatening hypothermia poses additional challenges. Rapid cooling of a patient's core temperature, especially when immobile or poorly insulated, necessitates early prevention. Modified algorithms like the military MhARCH therefore prioritize hypothermia management alongside hemorrhage control in extreme conditions. This article advocates for the crABCDE approach in civilian rescue, emphasizing immediate hypothermia prevention in cold, wet, or high-altitude environments. Tailored protocols that consider environmental risks and patient factors are essential for improving outcomes in both military and civilian trauma care.