Circulatory Support

In Tactical Combat Casualty Care (TCCC), the MARCH protocol is a step-by-step sequence for managing trauma in high-threat or austere environments. It prioritizes life-threatening conditions in the order most likely to kill a casualty. Following MARCH ensures nothing critical is missed under stress.

While dedicated primarily to military personnel, it can be modified for civilian public safety use, hence the C-TECC standards.

M – Massive Hemorrhage

Uncontrolled bleeding is the leading preventable cause of combat death.

• Apply a tourniquet high and tight on the limb. Yes, we know about the other landmarks too, but this is meant for a broader audience.
• Use hemostatic gauze and pressure dressings for junctional wounds.
• Reassess for hidden bleeding during patient movement.

A - Airway

Ensure the casualty can breathe effectively.

• Use manual maneuvers (chin lift/jaw thrust) if needed.
• Insert a nasopharyngeal airway (NPA) for semi-conscious patients.
• Surgical airway (cricothyrotomy) may be necessary if obstruction persists. A VERY advanced technique.

R – Respiration

Address penetrating chest trauma and prevent tension pneumothorax.

• Apply vented chest seals to all open chest wounds.
• Monitor for signs of respiratory distress.
• Perform needle decompression if indicated and trained. Another advanced technique.
  

C – Circulation

Control shock and maintain blood flow to vital organs.

• Initiate IV/IO access if needed for fluid resuscitation.
• Use blood products when available; avoid excessive crystalloids.
• Keep the casualty warm to prevent hypothermia-induced coagulopathy.
  

H – Hypothermia / Head Injury

Even in hot climates, trauma patients can become dangerously cold.

• Use hypothermia prevention wraps or blankets.
• Protect the brain—avoid hypotension and hypoxia in head injuries.
• Reassess neurological status regularly.
  

Why It Matters:

The MARCH protocol is designed for rapid, repeatable decision-making in chaotic environments. Whether you’re carrying a basic IFAK or a full advanced trauma kit, organizing your interventions according to MARCH dramatically improves survivability when every second counts.

At MED-TAC International, our kits are built with MARCH in mind—ensuring you have the right tools, in the right order, to execute life-saving care under fire.