What is the first priority in the MARCH algorithm used in Tactical Combat Casualty Care?

• A. Control of Massive Hemorrhage
• B. Airway Management
• C. Breathing Support
• D. Circulation Assessment

Answer: (A)

Massive hemorrhage control is the first action in MARCH because uncontrolled external bleeding is the number one immediate threat to life on the battlefield. Rapid blood loss can lead to shock and death within minutes, so stopping the bleed with tourniquets, wound packing, or hemostatic dressings takes priority over other interventions. Once the bleeding is controlled, you move on to airway management to ensure patency and oxygenation, then breathing support if needed, and finally circulation assessment and support. The emphasis is on saving the casualty by preventing exsanguination first, which is why this option is the best answer.