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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 security video still showing a lobby with desks covered with spurting blood and a clear trail of blood leading to a suspect about to die from blood loss by the revolving door

Brazilian Bank Robbery: Lethality of penetrating neck wounds

Fatal Penetrating Neck Wounds 🕖 Reading Time, 4 minutes Originally published Feb 25, 2023, but updated based on recent events and questions from students.  This video of an attempted bank robbery in Brazil shows that some injuries are just too …

A chart comparing the differences between proposed mnemonics MARCH and MATCH

Tactical Resuscitation: 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 …

A chest CT image of a pediatric patient, labeling how close the internal structures are to the chest wall

Pediatric Needle Decompression: Are We Using the Right Site and Needle Length?

Researched and written by Mike Shertz, MD/18D, not AI Pediatric-specific needle decompression recommendations remain an evolving discussion 🕖 Reading Time, 4 minutes While adult guidelines for needle decompression for tension pneumothorax are well established, pediatric-specific recommendations remain an evolving discussion. …