Identifying and controlling massive hemorrhage (the M in MARCH PAWS) remains the priority in Tactical Field Care.

All limb tourniquets hastily placed high and tight in CUF need to be reassessed and deliberate tourniquets placed for any extremity hemorrhage not previously addressed.

Junctional hemorrhage is compressible external hemorrhage not amenable to limb tourniquets and must be treated without delay using CoTCCC-recommended junctional tourniquets or improvised junctional hemorrhage control techniques with hemostatic dressings and direct pressure.

Other methods for addressing massive hemorrhage include injectable hemostatic agents and wound closure devices.