What Is the MARCH Algorithm? A Practical Trauma-Care Framework

MARCH is a trauma-assessment and treatment-priority framework used in Tactical Combat Casualty Care (TCCC) and related tactical-medicine training. The current Joint Trauma System terminology describes MARCH as Massive Hemorrhage, Airway, Respirations, Circulation, and Head/Hypothermia.

The value of MARCH is not that it turns trauma care into five easy steps. It gives trained responders a consistent order for thinking about problems that can become fatal quickly.

What Does MARCH Stand For?

M — Massive Hemorrhage

Life-threatening bleeding is addressed first because severe hemorrhage can kill rapidly. In a medical-kit context, this is why trauma-focused kits place appropriate hemorrhage-control supplies where they can be reached quickly rather than buried beneath lower-priority items.

A — Airway

After immediate catastrophic bleeding concerns, the framework turns to whether the casualty can maintain an airway. The specific assessment and interventions depend heavily on training and scope of practice.

R — Respirations

This stage focuses on breathing and serious chest or respiratory problems. Again, the equipment and interventions appropriate for a trained medical responder are not automatically appropriate for every first-aid-kit owner.

C — Circulation

Circulation includes assessing for shock and other perfusion concerns after the highest-priority immediate threats have been addressed. In real trauma care, this is far more than simply checking whether someone has a pulse.

H — Head Injury / Hypothermia

Current Joint Trauma System materials use the final H to encompass Head injury and Hypothermia. Preventing heat loss is an important part of trauma care even in environments that do not initially feel cold, and changes in mental status can be an important sign of serious injury.

Why the Order Matters

MARCH is a priority sequence. It is designed to keep a responder from becoming distracted by an obvious but lower-priority injury while a more immediate threat is present.

That same idea translates surprisingly well to medical-kit organization: the most urgent categories should be easy to identify and access. A perfectly stocked kit is not very useful if the item you need is buried under unrelated supplies.

Using MARCH to Organize a Medical Kit

You do not have to build a military IFAK to borrow the organizational logic of MARCH. A refillable medical bag can use labeled compartments to separate trauma priorities from routine first aid.

For example, a user might dedicate clearly marked sections to hemorrhage control, airway/respiratory equipment appropriate to their training, circulation/support items, hypothermia-related supplies and a separate area for everyday first aid or PPE.

The goal is not to force every item into an acronym. The goal is to create an organization system that remains understandable under stress.

MARCH and the IFAK

MARCH is one reason the terms IFAK and trauma kit frequently appear together. A trauma-focused individual kit is often organized around the kinds of immediate threats prioritized in tactical medicine.

If you are new to the terminology, start with What Is an IFAK? and our First Aid Kit vs. Trauma Kit guide.

Building the System Around Your Training

The Aska Aid Kit 2.0 uses a refillable, labeled six-compartment layout so the bag can be configured around a broad first aid loadout, trauma-focused setup or MARCH-inspired organization.

That does not mean every owner should carry every piece of advanced trauma equipment. A good medical kit reflects what its user is trained and prepared to do.

Use Current Training, Not an Acronym Alone

MARCH is a framework, not a replacement for formal education. TCCC guidance evolves as evidence and battlefield experience change. The Committee on Tactical Combat Casualty Care, part of the Joint Trauma System, maintains current TCCC guidance and directs users to Deployed Medicine for up-to-date educational materials.

This article is for education and equipment-organization context only. It is not a substitute for formal medical training, clinical judgment or emergency medical care.