The M.A.R.C.H. Algorithm

The M.A.R.C.H Algorithm

Tactical Combat Casualty Care (TCCC) emerged in 1996 by special operations forces stemming from lessons learned during previous conflicts with large scale adoption by US and allied forces after the events of September 11, 2001. Tactical Combat Casualty Care guidelines are evidence-based and battlefield-proven to reduce deaths at the point of injury (POI). Department of Defense (DOD) and most NATO allies require TCCC training for deploying forces because it combines effective tactics and medicine to reduce preventable death. TCCC teaches first responders to treat casualties in the proper order, treating the most critical situations first. This is accomplished by using the MARCH algorithm for easy memorization for seasoned medical providers as well as immediate responders using self-aid and buddy aid. There are many variations of the MARCH algorithm that adds tasks both before and after, but the base to prevent most preventable death is MARCH.

The MARCH algorithm is laid out differently from Advanced Trauma Life Support (ATLS) which used Airway, Breathing, and Circulation (ABC’s) as the order of treatment. MARCH stands for Massive Hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head injury. This order prioritizes bleeding control as the first step since morbidity and mortality linked to massive hemorrhage can happen in some cases twice as fast compared to airway and breathing complications.