MARCH-PAWS
This is the absolute first medical priority upon transitioning from Care Under Fire to Tactical Field Care.
massive hemorrhage control
This is the preferred first-line physical maneuver or basic airway adjunct for an unconscious casualty without airway obstruction.
Nasopharyngeal Airway (NPA) or a recovery position
This fluid is the absolute first choice for hemorrhagic shock resuscitation according to TCCC guidelines.
cold stored whole blood
Hypothermia prevention should begin at this point in the MARCH sequence, even if the ambient environment is warm.
During the 'H' phase of MARCH
When applying a limb tourniquet during Care Under Fire, it should be placed in this specific location relative to the clothing.
High and tight / over the clothing
This surgical procedure is indicated at the Tier 4 level if a casualty has severe maxillofacial trauma and simpler airway measures have failed.
surgical cricothyroidotomy
When whole blood is unavailable, TCCC prioritizes plasma, RBCs, and platelets in this specific, balanced ratio.
1:1 ratio
This is the specific item that should be applied over a suspected penetrating eye injury to prevent further pressure on the globe.
rigid eye shield
This is the maximum amount of time a tourniquet should remain in place before an attempt should be made to convert it to a hemostatic dressing, provided criteria are met.
2 hours
This is the anatomical location where a needle decompression of the chest (NDC) should be performed using the primary anterior site.
second intercostal space in the midclavicular line
This antifibrinolytic drug should be administered as soon as possible (and within 3 hours) to casualties anticipating a need for significant blood transfusions.
Tranexamic Acid (TXA)
You should completely avoid applying this type of dressing to a casualty with a suspected globe injury.
Pressure Dressing
You should never attempt to convert a tourniquet if the casualty is in this clinical state, or if the amputation is complete.
Combat shock
Per TCCC guidelines, this is the recommended size (gauge and length) of the needle/catheter device used to perform a needle chest decompression.
10-gauge, 3.25-inch needle
This is the target systolic blood pressure or physical indicator (such as a palpable pulse) you are looking for when resuscitating a patient in hemorrhagic shock without a TBI.
BP of 80–90 mmHg systolic or a palpable radial pulse
Hypothermia, acidosis, hypocalcemia, and this blood-clotting abnormality make up the deadly "Lethal Diamond"
Coagulopathy
In the MARCH-PAWS acronym, the letters "P" and "A" toward the end of the sequence stand for these two critical evaluation steps.
Pain (management) & Antibiotics
If a casualty's initial tension pneumothorax symptoms resolve after an NDC but later return, you should execute this specific physical intervention next.
perform a second NDC or flush initial NDC.
Unlike standard trauma, if a casualty has a suspected Traumatic Brain Injury (TBI) and cannot follow commands, fluid resuscitation must be aggressive enough to maintain a systolic blood pressure of at least this high.
110 mmHg systolic
This active heating blanket system is commonly issued in TCCC kits to rewarm casualties and should be placed directly over the casualty's shirt, not bare skin.
Ready-Heat blanket