Which element is the second in the MARCH sequence?

Which element is the second in the MARCH sequence?

• A. Massive hemorrhage
• B. Airway
• C. Respiration
• D. Circulation

Answer: (B)

In trauma care, priorities are arranged to save the most lives first, and the second step in that sequence is keeping the airway open. Massively bleeding wounds are addressed first because rapid blood loss can kill within minutes, so you must control the hemorrhage before anything else. Once the bleeding is under control, you move to securing and maintaining a patent airway to ensure the patient can breathe and receive oxygen. Without a clear airway, no amount of breathing support helps because air cannot reach the lungs or oxygenate the blood. After the airway is addressed, you then attend to breathing support and later to circulation and perfusion, following the order of how quickly each issue becomes life-threatening in a trauma situation.

In trauma care, priorities are arranged to save the most lives first, and the second step in that sequence is keeping the airway open. Massively bleeding wounds are addressed first because rapid blood loss can kill within minutes, so you must control the hemorrhage before anything else. Once the bleeding is under control, you move to securing and maintaining a patent airway to ensure the patient can breathe and receive oxygen. Without a clear airway, no amount of breathing support helps because air cannot reach the lungs or oxygenate the blood. After the airway is addressed, you then attend to breathing support and later to circulation and perfusion, following the order of how quickly each issue becomes life-threatening in a trauma situation.