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MARCH: Massive Hemorrhage, Airway, Respiration, Circulation, Hypothermia Prevention

The easy to remember mnemonic MARCH reminds us of the priorities in treating casualties during TECC and TCCC situations. MARCH provides a framework to address immediate life threats and gives an organized approach to begin a casualty evaluation. The MARCH mnemonic is preferable to the ABCDE model because it takes into consideration the reason you need an airway and to be breathing is to circulate blood to the casualty’s brain. Recognizing that, the first step in our casualty evaluation should be to look for massive hemorrhage.

Once past massive hemorrhage, A-R-C is loosely approximated by A-B-C. H- is a reminder that a large number of traumatic casualties arrive at the emergency department or medical treatment facility hypothermic which dramatically increases their death rate.

The MARCH mnemonic can be applied to any patient, as the initial casualty evaluation usually rules out massive hemorrhage.

A cartoonized version of the newly marketed SEAL spray, appearing to have been drawn in crayon

Evaluation of SEAL Hemostatic Spray: Marketing Claims vs. Published Data

Recently, both a Special Forces Medic and a civilian fire paramedic asked me about a new hemostatic product being actively marketed on social media: SEAL Hemostatic Wound Spray. Like many things on social media, you have to check the veracity: …

A chart comparing the differences between proposed mnemonics MARCH and MATCH

Tactical Resuscitation in 2025: Rethinking MARCH for the Blood Product Era

Co-TCCC considered changing the MARCH mnemonic to include resuscitation, or more specifically transfusion. Researched and written by Mike Shertz, MD/18D, not AI 🕖 Reading Time, 4 minutes In 2025, with the widespread use of blood started prehospital to resuscitate US …