Once life-threatening hemorrhage has been addressed, the remaining MARCH sequence assessments and treatments can proceed. If you identify an airway obstruction, you should open it using either airway maneuvers or airway adjuncts. If those are not successful, you may need to establish an airway.

Sometimes an additional responder, such as a Combat Lifesaver, may be needed to help maintain an airway once re-established. Respiratory insufficiency may be from several different causes, and common trauma sources often respond to chest seals, or needle decompression(s) of the chest if a tension pneumothorax is present.

Circulation often focuses on applying a pelvic binder for cases of suspected pelvic fractures, reassessing prior tourniquet application, treating shock (when present), establishing intravenous or intraosseous access, and treating hemorrhagic shock with blood products.

Treat hypothermia with active and passive measures. Consider it a risk despite the ambient temperature of the environment. Assess, treat, and document all head and penetrating eye injuries.