Why Does the MARCH Protocol Prioritize Respiration Before Circulation?

Question: Why does the MARCH protocol prioritize respiration before circulation?

Survival Med’s Answer: In reality, the assessment of Airway, Respiration, and Circulation often occurs concurrently or in rapid succession.

The primary focus is determining if the victim is breathing and if they have a pulse. The sequence may vary based on the situation:

1. No Pulse and No Breathing: Initiate CPR with 30 compressions followed by 2 breaths. This addresses the absence of both circulation and respiration.
2. Pulse Present but Difficulty Breathing: Reposition the airway and consider providing assisted breaths.

The MARCH acronym serves as a mnemonic device to aid in remembering key steps, but in critical situations, the assessment is dynamic.

Quick decisions are made based on the immediate needs of the victim, whether it involves addressing circulation, respiration, or both simultaneously.