Trauma Nurse Core Course (TNCC) Practice Exam

Which mnemonic should the nurse use to prioritize care for a trauma patient with massive uncontrolled hemorrhage?

1. ABC

2. MARCH

3. AVPU

4. VIPP

The correct answer is: MARCH

The mnemonic MARCH is specifically designed for the management of trauma patients, particularly in the context of hemorrhagic shock. MARCH stands for Massive hemorrhage, Airway, Respiration, Circulation, and Head injury/hypothermia. This mnemonic emphasizes the critical steps that need to be taken in an emergency situation involving massive hemorrhage. In the case of massive uncontrolled hemorrhage, the first step is to address the massive hemorrhage itself. This prioritization is essential because uncontrolled bleeding is the most immediate and lethal threat to a trauma patient. By using MARCH, the nurse can systematically approach the most pressing issues, ensuring that life-threatening hemorrhaging is controlled as quickly as possible, often through direct pressure, the use of tourniquets, or other methods of hemorrhage control. The other mnemonics, while relevant in certain contexts, do not specifically focus on the urgent response required for massive uncontrolled hemorrhage. For instance, ABC emphasizes airway, breathing, and circulation, which, while critical, does not prioritize the immediate need to stop bleeding first. Similarly, AVPU assesses a patient's level of consciousness and neurological status, and VIPP relates to vital signs and patient positioning, both of which are less critical than immediately managing bleeding in