MARCH Master Card

M Massive Hemorrhage

• Identify: Blood pooling, spurting, soaked clothing
• Extremity: Tourniquet HIGH and TIGHT
• Junctional: Wound pack + direct pressure 3+ min
• Reassess: If bleeding continues, add second TQ

A Airway

• Conscious + talking: Airway clear, monitor
• Unconscious: Head-tilt/chin-lift, recovery position
• Obstructed: Suction, NPA, jaw thrust
• Don’t force: If breathing OK, move on

R Respiration

• Expose chest: Look for wounds, asymmetry
• Open wound: Chest seal (vented preferred)
• Tension pneumo signs: Distress, absent sounds, tracheal shift
• Tension pneumo treatment: Needle decompression

C Circulation

• Assess shock: Mental status, pulse, skin color
• If shocked: Verify hemorrhage controlled
• IV/IO access: If trained and equipped
• Target: Palpable radial pulse (unless head injury)

H Hypothermia / Head

• Prevent heat loss: Remove wet, insulate above/below
• Cover head: Major heat loss area
• Head injury: Assess LOC, pupils, maintain normal BP
• Document: Baseline neuro status for handoff

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