Accident · Airway · Airway & Breathing · casualty · Chest Trauma · Education · first responder · gunshot wound · Head Trauma · paramedic · police · Resuscitation · tactical medicine · Trauma · wound packing ·Apr 29, 2025

The MARCH Approach: Find & Treat

In high-stress trauma situations, having a clear, effective assessment framework can make all the difference. While most first responders are familiar with the DRSABCDE framework, here at TacMed, we don't believe this is always ideal for trauma scenarios. Enter the MARCH primary survey - a superior alternative that combines assessment and treatment in a practical "treat as you find" approach.

Why MARCH Over Traditional Frameworks?

The MARCH primary survey prioritises life-threatening issues in order of urgency, starting with massive haemorrhage before airway management. As you probably know by now, team TacMed is big on bleeding control, and this framework supports our view that stopping major haemorrhage must be the first priority in trauma care. After all, without blood, having a clear airway becomes irrelevant.

Breaking Down MARCH

M - Massive Haemorrhage

First priority: Control life-threatening bleeding
Focus on "oh shit" bleeding - neck, armpits, groin, extremities
Treat immediately with direct pressure, tourniquets, wound packing and and haemostatic agents
Recommended gear: CAT tourniquet, SOF tourniquet , Quikclot Combat Gauze, Emergency Bandage, OLAES Modular Trauma Bandage and SAM Junctional Tourniquets for groin or axilla wounds.

Two paramedics in green uniforms and blue gloves treat a patient with a severe leg wound, applying pressure and bandages, while blood is visible on the ground during an emergency response.

A - Airway

Assess for actual or potential obstructions
Listen for wheezing, stridor, hoarse voice
For unconscious patients: perform a thorough assessment and appropriate interventions.
Recommended gear: Nasopharyngeal airways, Pocket BVM, Guedel Airway Kit , Tactical Suction Device, and TacMed Oxygen Delivery Kit.

A paramedic in a green uniform and blue gloves inserts a Guedel airway into a patient’s mouth to maintain an open airway during emergency medical care, with the patient lying on an orange blanket.

R - Respiration

Check breathing presence and adequacy
Expose the chest - look, listen, feel
Assess for tension pneumothorax, rib fractures, flail segments
Apply chest seals, needle decompression as needed
Recommended gear: HyFin Chest Seals, ARS needle decompression kits , Halo Chest Seals, and i-Gel Supraglottic Airway

A close-up of a paramedic in blue gloves performing a needle decompression on a patient’s chest to treat a tension pneumothorax during an emergency medical procedure.

C - Circulation

Reassess bleeding interventions
Fully expose and properly dress wounds
Control non-life-threatening bleeding
Assess the abdomen and pelvis for injuries
Take baseline vital signs
Start IVs, manage pain, splint fractures and treat burns
Recommended gear: SAM pelvic binders, Slishman Traction Splint, SAM Splint , Triangular Bandages, Wound Dressings, Stethoscope, Finger Pulse Oximeter.

A paramedic in a green uniform and blue gloves kneels beside a patient on the ground, placing a finger pulse oximeter on the patients finger, with medical equipment like a monitor and oxygen mask nearby, amidst a scene with blood on the floor.

H - Head Injury/Hypothermia

Assess for head trauma - pupils, GCS, mental status
Prevent hypoxia and hypotension (maintain BP >90-100mmHg)
Avoid hyperventilation
Actively prevent hypothermia - remove wet clothing, use warming techniques
Remember: Trauma patients below 34°C have ~60% mortality
Recommended gear: Slishman Pressure Wrap, Conforming Bandage, and Thermal Emergency Blanket for preventing heat loss.

Two paramedics in green uniforms and blue gloves treat a patient with a severe leg wound, applying a thermal blanket to keep their patient warm and prevent shock, while blood is visible on the ground during an emergency response.

SMARCH Variation

A useful variation is SMARCH, where the 'S' stands for Scene Security/Safety - reminding us to maintain situational awareness throughout the assessment. If you want to learn more about this topic, check out our dedicated blog [ Situational Awareness ]

Alt text: Two paramedics in green uniforms with reflective stripes stand near a TacMed Medical Services van, holding medical bags, preparing for an emergency response on a wet day.

Key Takeaways

The MARCH framework isn't necessarily a linear process. The systematic approach will ensure you don't miss any critical injuries from point of injury to hospital handover, however it's important to remember to continuously reassess your interventions and patient status along the way.

As always, we appreciate all of you who are sharing our content with your colleagues, friends, and family. By raising awareness and being emergency prepared, we can all make a difference, when it matters most – saving lives and preventing tragedy.

Summary

In trauma situations, every second counts. The MARCH primary survey offers a practical, life-saving framework that prioritises treatment in the order of urgency—starting with Massive Haemorrhage, followed by Airway, Respiration, Circulation, and Head injury/Hypothermia. Unlike traditional protocols, MARCH takes a “treat as you find” approach, ensuring immediate action on the most lethal threats first. From tourniquets and chest seals to airway adjuncts and warming devices, this method ensures no step is missed from the scene to hospital handover. For first responders, medics, or remote operators, MARCH delivers structure when it matters most.

FAQs

What is the MARCH primary survey?

MARCH is a trauma care assessment framework that stands for Massive Haemorrhage, Airway, Respiration, Circulation, and Head injury/Hypothermia. It prioritises life-threatening issues in order of urgency and guides responders through treatment in high-stress trauma scenarios.

Why does MARCH prioritise bleeding over airway?

MARCH starts with Massive Haemorrhage because a patient can bleed to death in under 3 minutes. Without blood, having a clear airway becomes irrelevant. This prioritisation improves survival rates in trauma care, especially in prehospital or combat environments.

What’s the difference between MARCH and DRSABCDE?

DRSABCDE focuses on general first aid assessment, while MARCH is designed for trauma-specific scenarios. MARCH places bleeding control first and integrates treatment as part of the assessment, making it more effective in time-critical trauma situations.

What gear is recommended for the MARCH framework?

Each step of MARCH has specific recommended tools: tourniquets and haemostatic agents for bleeding, NPAs and BVMs for airway, chest seals for respiration, pelvic binders and splints for circulation, and thermal blankets for hypothermia. TacMed provides kits tailored to this framework.

What does the ‘S’ stand for in SMARCH?

In the SMARCH variation, the ‘S’ stands for Scene Safety or Security. It reminds responders to continually assess threats to themselves or the patient during an incident, maintaining situational awareness at all times.

Can civilians use the MARCH framework?

Yes. While originally developed for military and tactical medics, MARCH is now widely taught to paramedics, first responders, and civilians. It offers a clear and logical approach to treating trauma victims, even for those with basic medical training.

Related Products & Resources

Tourniquets – C-A-T, SOF, and other field-tested models for haemorrhage control
Haemostatic Dressings – QuikClot Combat Gauze, Emergency Bandage, and OLAES
Airway & Breathing – NPAs, BVMs, chest seals, and ARS decompression needles
Splints – SAM Splints, Slishman Traction Splint, and SAM Pelvic Binders
Hypothermia Prevention – Thermal Blankets, Pressure Wraps, and warming supplies
TacMed Training Courses – Learn how to apply MARCH in real-world scenarios

Need advice on selecting the right trauma first aid gear or kits for your role? Reach out to us via phone 1300-862-633 or email info@tacmedaustralia.com.au and stay in touch on socials @tacmedaustralia.

Stay Safe,

Team TacMed