TCCC · Trauma
MARCH Protocol
The primary trauma assessment sequence for tactical and austere environments. Addresses life threats in order of lethality.
MMassive Hemorrhage — tourniquet, wound pack
AAirway — NPA, positioning, cric if needed
RRespiration — chest seal, needle decompression
CCirculation — shock management, permissive hypotension, TXA
HHypothermia — insulate, remove wet clothing, warm fluids
EMS · Civilian
S-CABCDE Assessment
Civilian systematic trauma assessment used in EMS, PHTLS, and emergency departments. Includes scene safety and cervical spine.
SScene Safety — 360° scan, perimeter, call EMS
CCatastrophic Hemorrhage — tourniquet, direct pressure
AAirway — jaw thrust if spinal concern
BBreathing — rate, SpO₂, chest auscultation
CCirculation — shock class, IV access
DDisability — AVPU/GCS, pupils, glucose
EExposure — full inspection, log roll, insulate
Military · Aviation
9-Line MEDEVAC Request
Standard NATO format for requesting medical evacuation by air. Essential for military, expedition, and remote operations.
1Location of pickup site (grid / coords)
2Radio frequency, callsign, suffix
3Number and precedence (A/B/C/D/E)
4Special equipment needed
5Number of casualties by type
6Security at pickup site
7Method of marking site
8Patient nationality and status
9NBC contamination (if any)
Handoff · Communication
ZMIST / MIST Handoff
Structured casualty handoff format used when transferring care. Ensures critical information is transmitted rapidly and accurately.
ZZulu time — time of injury (24hr format)
MMechanism — how was the injury caused?
IInjuries — what was found during assessment?
SSigns — vital signs at time of handoff
TTreatment — interventions performed so far
Practice these protocols in realistic scenarios
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