What does 'M' represent in the MARCH protocol?

In the MARCH protocol, which is a systematic approach used in tactical combat casualty care (TCCC), the 'M' stands for Massive hemorrhage. This is a critical component of trauma care as it emphasizes the importance of identifying and controlling life-threatening bleeding during the initial assessment and treatment of casualties. Dealing with massive hemorrhage immediately can significantly increase the chances of survival for the injured individual.

Controlling bleeding is prioritized because uncontrolled hemorrhage is one of the leading causes of preventable death in trauma situations. The protocol encourages the responder to use effective methods such as direct pressure, tourniquets, or hemostatic agents to manage the bleeding before moving on to other aspects of treatment. Recognizing the severity of hemorrhage early allows for prompt intervention, which is vital in a combat or emergency setting.