In tactical casualty care, which condition is the first priority in the MARCH sequence?

In tactical casualty care, which condition is the first priority in the MARCH sequence?

• A. Airway
• B. Breathing
• C. Massive bleeding
• D. Hypothermia

Answer: (C)

Massive bleeding control is the primary concern. In tactical casualty care, stopping life-threatening hemorrhage right away is the most time-critical action because rapid blood loss can lead to death within minutes. That’s why the first step in the MARCH sequence is to address massive external bleeding—use direct pressure, tourniquets, or hemostatic dressings to control hemorrhage before moving on to airway and breathing. Once bleeding is under control, you then manage the airway and breathing to ensure you’re ventilating the patient, followed by circulation considerations and preventing hypothermia. The other issues are important, but without stopping the bleeding first, the risk of exsanguination remains highest.

Massive bleeding control is the primary concern. In tactical casualty care, stopping life-threatening hemorrhage right away is the most time-critical action because rapid blood loss can lead to death within minutes. That’s why the first step in the MARCH sequence is to address massive external bleeding—use direct pressure, tourniquets, or hemostatic dressings to control hemorrhage before moving on to airway and breathing. Once bleeding is under control, you then manage the airway and breathing to ensure you’re ventilating the patient, followed by circulation considerations and preventing hypothermia. The other issues are important, but without stopping the bleeding first, the risk of exsanguination remains highest.