What is the first step in the MARCH assessment?

In the MARCH assessment, the first step is to assess and manage massive hemorrhage. This prioritization is rooted in the understanding that uncontrolled bleeding is the leading cause of preventable death in trauma patients. By addressing massive hemorrhage first, medical responders can stabilize the patient and mitigate life-threatening blood loss before other injuries or conditions are managed.

Massive hemorrhage often requires immediate intervention, such as applying direct pressure, utilizing tourniquets, or packing wounds, to control bleeding effectively. This step is critical because, without rapid management of significant blood loss, the patient's chances of survival diminish significantly. Following the control of massive hemorrhage, the assessment can continue with airway management, circulation assessment, and environmental considerations, but the priority remains on preserving life through the control of bleeding first.