Evidence-Based Trauma Framework

The MARCH Protocol

MARCH is the casualty-assessment sequence used by military and civilian responders to treat the leading causes of preventable death from traumatic injury. This guide walks through each step in order, explains the clinical reasoning, and connects you to the equipment for each phase.

M Massive Hemorrhage

A Airway Management

R Respiratory Support

C Circulatory

H Head / Hypothermia

Aligned with CoTCCC / C-TECC guidance Medical SME Veteran-Led Kits Assembled in the USA

The Sequence

Why the Order Matters

Each letter addresses a cause of death that kills faster than the one after it. Massive hemorrhage can kill in minutes; hypothermia complicates every later intervention. Treat in sequence, reassess constantly.

Step 01

Massive Hemorrhage

Why it's first: Uncontrolled arterial bleeding from limb trauma is the most survivable cause of preventable death when treated immediately. A casualty can lose a lethal volume of blood in under five minutes from a femoral artery injury, long before any airway or breathing problem becomes fatal.

Shop Massive Hemorrhage High and tight on the limb, over clothing, tightened until bleeding stops.

Step 02

Airway Management

Why it's second: Once catastrophic bleeding is controlled, the airway is the next immediate threat. An unconscious casualty cannot protect their own airway; positioning and simple adjuncts restore oxygen delivery within seconds.

Shop Airway Management For professionals trained in airway management; verify scope of practice.

Step 03

Respiratory Support

Why it's third: A penetrating chest wound can collapse a lung progressively. Chest seals and, for trained providers, needle decompression restore ventilation before the casualty deteriorates. Naloxone for suspected opioid overdose is carried and administered under this phase of civilian response.

Shop Respiratory Support Chest seals: apply over the wound, wipe the skin, burp if tension develops.

Step 04

Circulatory

Why it's fourth: Circulation covers shock recognition and bleeding that tourniquets cannot reach: junctional and truncal wounds, packing with hemostatic gauze, and pressure dressings. IV access and fluid resuscitation belong to credentialed providers operating within their protocols.

Shop Circulatory Pack the wound, direct pressure, then wrap. Reassess every intervention.

Step 05

Head / Hypothermia

Why it's last: Head injury monitoring and hypothermia prevention protect the casualty after immediate threats are managed. Hypothermia is one arm of the Lethal Triad (hypothermia, acidosis, coagulopathy): a cold casualty clots poorly, so every prior intervention works worse.

Shop Head / Hypothermia Insulate from the ground up: the casualty loses heat fastest lying on cold surfaces.

Build At Your Level

MARCH-Ready Kits By Mission

Three tiers, from individual carry to team and mass-casualty response. Every kit is assembled around the MARCH sequence.

Tier 1 Individual Carry

MED-TAC Custom Trauma Kit

$139.95 View Details

5 / 5 · 3 reviews

D-BAG IFAK KIT - Advanced

$189.95 View Details

Ultra-Compact Trauma IFAK – Bleeding Control Kit

$199.00 View Details

Tier 2 Staged Response

Premium Range Trauma Kit - HARD CASE

$224.99 View Details

MED-TAC First Response Backpack Kit

$339.99 View Details

Enhanced Vehicle Trauma Kit – NANUK 904 Hard Case System

$399.00 View Details

Tier 3 Team / MCI

High Risk Warrant Casualty Kit

$459.99 View Details

Rapid Response Kit - Rescue Task Force Version

$499.00 View Details

Mini-Medic Bag Kit

$649.99 View Details

Verified

Reviewed 2026

MED-TAC International
Clinical Review Board

Clinical Sources

The Evidence Behind The Sequence

✓
Extremity hemorrhage is the leading preventable cause of death in traumatic injury. Tourniquet application before the onset of shock is consistently associated with improved survival. Kragh et al., Ann Surg, 2009
✓
Hypothermia worsens coagulopathy. The Lethal Triad is a recognized framework in trauma care; preventing heat loss is part of the damage-control sequence. Gentilello et al., J Trauma, 1997
✓
Civilian bleeding-control programs improve outcomes. Public access bleeding control training and kit placement reduce time-to-tourniquet in intentional-injury events. Ross et al., J Trauma Acute Care Surg, 2018

MARCH alignment references CoTCCC and C-TECC guidance as educational frameworks. Guidance alignment is not a certification. Always operate within your training, protocol, and scope of practice.

Know What You Need

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Assemble a MARCH-aligned kit piece by piece. Discounts apply automatically as you add unique items.

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Agencies & Teams

Team Procurement & Quotes

Standardized MARCH kits at scale, with sourcing, assembly, and agency-ready documentation.

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Go Deeper

The MARCH Protocol