From the MARCH Mnemonic Series – Tactical Trauma Care for EMS Providers
When seconds count and conditions are unpredictable, the MARCH mnemonic. provides a clear, evidence-based sequence for trauma management in both tactical and civilian emergency settings.
Standing for Massive Hemorrhage, Airway, Respiration, Circulation, and Hypothermia/Head Injury, this structured approach originated in Tactical Combat Casualty Care (TCCC) and has become a cornerstone of modern prehospital and field medicine.
From the battlefield to the back roads, MARCH helps rescuers- military medics, EMS providers, law enforcement officers, and trained civilians - prioritize interventions in the order most likely to save lives.
By following this systematic progression, responders can rapidly identify and treat life-threatening conditions while preventing secondary injury and deterioration during evacuation.
Each installment in this upcoming series explores one element of MARCH, offering concise guidance, field considerations and key takeaways tailored for EMS and tactical responders: - Part One: Massive Hemorrhage - Stop the bleed, save the life
- Part Two: Airway - Secure it early, maintain it always
- Part Three: Respiration - Restore the breath, relieve the pressure
- Part Four: Circulation - Preserve perfusion, prevent shock
- Part Five: Hypothermia & Head Injury - Protect the head, protect the brain
Whether in an urban response zone, rural rescue, or austere tactical environment, MARCH isn’t just a checklist - it’s a mindset. It empowers providers to think clearly, act decisively, and deliver lifesaving care under pressure.
Further Reading:
American College of Surgeons Committee on Trauma. (2022) Advanced Trauma Life Support (10th Ed). Chicago, IL: American College of Surgeons.
Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, MA: Pearson Education
Butler, F. K. (2017) Tactical Combat Casualty Care: Beginnings. Wilderness & Environmental Medicine 28 (2S): S12-S17. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28284483/ on October 8, 2025
Butler, F. K., Bennett, B., & Wedmore, C. I. (2017) Tactical Combat Casualty Care and Wilderness Medicine: Advancing Trauma Care in Austere Environments. Emergency Medicine Clinics of North America 35 (2): 391-407. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28411934/ on October 8, 2025
Committee on Tactical Combat Casualty Care (2023) Tactical Combat Casualty Care (TCCC) Guidelines for Medical Personnel. Defense Health Agency, Joint Trauma System. Retrieved from https://jts.health.mil on October 8. 2025
National Association of Emergency Medical Technicians NAEMT (2020) TECC: Tactical Emergency Casualty Care Course Book (2nd Ed). Burlington, MA: Jones & Bartlett Learning
National Association of Emergency Medical Technicians NAEMT (2023) Tactical Emergency Casualty Care (TECC) Guidelines. NAEMT Education Division
National Association of Emergency Medical Technicians NAEMT (2025) PHTLS: Prehospital Trauma Life Support, Military Edition eBook (10th Ed). Burlington, MA: Jones & Bartlett Learning
From the MARCH Mnemonic Series – Tactical Trauma Care for EMS Providers
- Part One: Massive Hemorrhage - Stop the bleed, save the life
- Part Two: Airway - Secure it early, maintain it always
- Part Three: Respiration - Restore the breath, relieve the pressure
- Part Four: Circulation - Preserve perfusion, prevent shock
- Part Five: Hypothermia & Head Injury - Protect the head, protect the brain
Whether in an urban response zone, rural rescue, or austere tactical environment, MARCH isn’t just a checklist - it’s a mindset. It empowers providers to think clearly, act decisively, and deliver lifesaving care under pressure.
Further Reading:
American College of Surgeons Committee on Trauma. (2022) Advanced Trauma Life Support (10th Ed). Chicago, IL: American College of Surgeons.
Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, MA: Pearson Education
Butler, F. K. (2017) Tactical Combat Casualty Care: Beginnings. Wilderness & Environmental Medicine 28 (2S): S12-S17.
Retrieved from https://pubmed.ncbi.nlm.nih.gov/28284483/ on October 8, 2025
Butler, F. K., Bennett, B., & Wedmore, C. I. (2017) Tactical Combat Casualty Care and Wilderness Medicine: Advancing Trauma Care in Austere Environments. Emergency Medicine Clinics of North America 35 (2): 391-407. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28411934/ on October 8, 2025
Committee on Tactical Combat Casualty Care (2023) Tactical Combat Casualty Care (TCCC) Guidelines for Medical Personnel. Defense Health Agency, Joint Trauma System. Retrieved from https://jts.health.mil on October 8. 2025
National Association of Emergency Medical Technicians NAEMT (2020) TECC: Tactical Emergency Casualty Care Course Book (2nd Ed). Burlington, MA: Jones & Bartlett Learning
National Association of Emergency Medical Technicians NAEMT (2023) Tactical Emergency Casualty Care (TECC) Guidelines. NAEMT Education Division
National Association of Emergency Medical Technicians NAEMT (2025)
PHTLS: Prehospital Trauma Life Support, Military Edition eBook (10th Ed). Burlington, MA: Jones & Bartlett Learning
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