The MARCH Approach: Find & Treat

The image shows two TacMed Australia healthcare providers treating a simulated trauma patient with visible blood, demonstrating the MARCH approach prioritising haemorrhage control in emergency medical response.

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

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

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

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

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.

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