Combat Triage and Mass Casualty Response

Combat triage and mass casualty response demand rapid decision-making, resource prioritization, and tactical flexibility under extreme stress. This chapter provides a practical framework that integrates the principles of triage, Tactical Combat Casualty Care (TCCC) phases, and the MARCH algorithm to manage battlefield casualties effectively. It emphasizes the three structured levels of triage—primary, secondary, and tertiary—aligned with Care Under Fire, Tactical Field Care, and Tactical Evacuation phases of TCCC. Using the MARCH sequence to address life-threatening conditions in a prioritized manner, the chapter outlines actionable strategies for hemorrhage control, airway management, shock stabilization, and hypothermia prevention in combat mass casualty scenarios. Real-world case scenarios illustrate how responders must continuously reassess, adapt, and balance mission objectives with casualty survival. The focus remains on maximizing lives saved, even when faced with overwhelming numbers and limited resources, by maintaining a dynamic, structured approach to casualty management from point-of-injury through evacuation.