# MARCH algorithm for combat casualty care



## Marauder06 (Sep 4, 2018)

I read the article, and while it seems good it's a little outside of my area of expertise.  However, as it was written by a former Ranger PA who's now in med school, it seems credible enough to post.



> The MARCH algorithm is synonymous with Tactical Combat Casualty Care (TCCC). It is a simple acronym for remembering the necessary steps in priority for saving lives in combat. M-massive hemorrhage, A-airway, R-respiratory, C-circulation, and H-hypothermia.
> 
> ...It is fantastic to see programs like TCCC and its associated methods (MARCH) making their way into civilian medicine and EMS. I know the author was well intentioned and wanted to share a great way to approach the trauma patient. It seems he was trying to take some standard EMS trauma care knowledge, apply the concept of MARCH, in order to improve on the current approach. I truly appreciate his efforts. However, there should be an understanding of why the point of injury care/battlefield medicine protocols are written in such a way and the evidence that supports it.


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## Muppet (Sep 6, 2018)

The very same PA by the name of @FisherAD1 ?


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## Devildoc (Sep 6, 2018)

While MARCH _should_ be used by every agency that puts hands on trauma, too few do it.  But I think it'll gain speed.  Dinosaurs in EMS are hard to slay, and saying something is evidence-based matters not.  A lot of civilian providers haven't a clue the depth and breadth of research in trauma care since 9/11.


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## Muppet (Sep 7, 2018)

Devildoc said:


> While MARCH _should_ be used by every agency that puts hands on trauma, too few do it.  But I think it'll gain speed.  Dinosaurs in EMS are hard to slay, and saying something is evidence-based matters not.  A lot of civilian providers haven't a clue the depth and breadth of research in trauma care since 9/11.



Yep. At least in my AO, suburban Philly, TECC/stop the bleed classes are a plenty. I used to teach TCCC/TECC, at my former gig. Each of our MICUs have an active killer bag, complete with one of those fancy mini SKEDs.


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## Diamondback 2/2 (Sep 7, 2018)

Man, I thought y'all just transported old folks to the worm farm...

I never thought of M.A.R.C.H. when I was slapping CATS on blenders... but I wasn't a medic!


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## Devildoc (Sep 7, 2018)

Diamondback 2/2 said:


> Man, I thought y'all just transported old folks to the worm farm...
> 
> I never thought of M.A.R.C.H. when I was slapping CATS on blenders... but I wasn't a medic!



You didn't get further than "M", but that's OK.  That's why it's first.  

You're like everyone else on this planet who thinks all EMS is "I call, you haul," and transport to the worm farm....


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