As you might expect, the TTA should begin by adhering to the MARCH PAWS sequence; understanding that massive hemorrhage assessment and treatment may begin in Care Under Fire while establishing fire superiority, extracting the casualty from burning vehicles or buildings, and moving them to safety, if appropriate. But most of the TTA occurs in Tactical Field Care, where further assessment and treatment following the full MARCH PAWS sequence can continue. Communication and documentation are key principles throughout the assessment.

As combat medics with additional skills and equipment, you may have time to perform a more detailed exam as part of a secondary assessment. The tactical trauma assessment can guide casualty care from point of injury through evacuation to higher-level care.