When dealing with patients involved in situations that cause massive traumatic injuries, a working knowledge of the MARCH protocol can possibly mean the difference between life and death. MARCH prioritizes treatment so that the first responder can rapidly access the situation and rapidly apply treatment in the most critical order that care should be received.


M - Massive hemorrhage

- control with tourniquet. ​

A - Airway

- jaw thrust or head-tilt. ​

R - Respirations

- artificial breathing, assess for chest wall trauma if no breathing. ​

C - Circulation / CSPINE

- control bleeding, reevaluate tourniquet. And consider cervical spine immobilization. ​

H - Hypo/Hyperthermia

- protect from the elements, Helicopter/Hike - create and execute a plan to stay or go