(MARCHE)2: INTEGRATING TCCC MARCH WITH CBRN FIRST RESPONSE

After initial assessment of casualties for the presence or absence of CBRN symptoms using the CRESS algorithm (and donning of PPE by first responders), the integrated assessment and management of TCCC and CBRN injuries can proceed.

The acronym (MARCHE)2 integrates the established TCCC MARCH algorithm (Massive Hemorrhage, Airway, Respirations, Circulation, Hypothermia) with CBRN MARCHE priorities (Mask, Antidotes, Rapid spot decontamination, Countermeasures, Extraction and Evacuation). Combining these two approaches gives the acronym (MARCHE)2 or “MARCH-squared.”

Similar to TCCC, (MARCHE)2 can be broken into phases of care from highest threat (care under fire or active CBRN threat), to intermediate threat (tactical field care or warm zone casualty management), to lowest threat (Prolonged Field Care (PFC)/evacuation or cold zone care of decontaminated casualties) (Figure 6 below).