MARCH: the order you check a casualty in, every time.
MARCH is the trauma-care sequence used by military and civilian first responders to find and treat the injuries most likely to kill a person first: Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head injury. Work the letters in order — don't skip ahead to a visible injury before ruling out the one that kills faster. This reference is included offline in every GridDownData vault; it does not replace professional medical training or care.
Tap each step to mark it checked as you work through an assessment. This page resets when you reload it — nothing is saved or transmitted.
- Scan the whole body fast for spurting or pooling blood — clothing hides wounds.
- Extremity bleed that won't stop with direct pressure: apply a tourniquet 2–3 inches above the wound, never on a joint. Write the application time on the strap.
- Junctional or torso bleed (groin, armpit, neck): pack the wound tightly with gauze and hold firm direct pressure — a tourniquet can't reach these.
- If bleeding continues after a tourniquet is fully tightened, apply a second one directly above the first.
- Check responsiveness. If unconscious and breathing, open the airway with a head-tilt/chin-lift.
- Suspect a spinal injury (fall, blast, vehicle collision)? Use a jaw-thrust instead — don't tilt the head.
- Clear visible obstructions (blood, vomit, debris) with a finger sweep only if you can see it.
- Breathing and unconscious with no spinal concern: place in the recovery position so the airway stays clear if they vomit.
- Look, listen, and feel for breathing for at least 10 seconds.
- Expose the chest. An open or "sucking" chest wound gets a chest seal — a 3-sided taped occlusive dressing works if you don't have a commercial seal.
- Watch for tension pneumothorax: worsening shortness of breath, one side of the chest not rising, bluish skin. This is a rapid-decline emergency — get to advanced care immediately if at all possible.
- Check a pulse. A radial (wrist) pulse present roughly correlates with a systolic blood pressure above 80 mmHg; if absent, check the carotid (neck).
- Re-scan for bleeding sources you may have missed in step M, including the back and scalp.
- Treat for shock: keep the person warm, lay flat with legs elevated if there's no suspected spinal or leg injury, and don't give food or water if surgery may be needed.
- Remove wet clothing and insulate the person from the ground — heat loss to cold ground is faster than to cold air.
- Cover to retain body heat; a reflective blanket or dry layers both work.
- Check pupil response and consciousness level using AVPU: Alert, responds to Verbal, responds to Pain, Unresponsive.
- Worsening confusion, repeated vomiting, or unequal pupils after a head injury are red flags for a serious traumatic brain injury — treat as a priority evacuation.
This reference is for use when professional medical care is delayed or unreachable. It does not replace training, a first-aid course, or a clinician's judgment. Seek qualified care as soon as it becomes available.
See the tool this sequence tells you to reach for: Tourniquet Application Guide. For the broader reference library, see Offline Medical Reference.
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