Stop the killing first, then the dying — the first 10 minutes of a trauma scene

"Stop the killing first, then the dying."

That's the order of operations on a casualty. It's the rule a Green Beret 18D Combat Medic carries from selection to retirement. Massive bleeding kills in minutes. Everything else has slightly more runway.

The MARCH-PAWS sequence in four lines

M — Massive hemorrhage. Stop it first. Tourniquet, then hemostatic gauze and pressure. If pulsing or pooling, the rules change.

A — Airway. Open it, keep it open, position the casualty so it stays open. Recovery position for unconscious patients who are breathing.

R — Respiration. Chest seals for penetrating injuries. Listen for sucking sounds and rapid breathing.

C — Circulation. After major bleeds are controlled, treat for shock. Warm them up. Keep them flat.

H — Hypothermia and Head. Cover them. Even in summer. Shock drops body temp fast.

P — Pain management (TCCC doctrine; civilian only when EMS arrives).

A-W-S — Antibiotics, Wounds, Splints (later phases — not the first 10 minutes).

The civilian gap

Most people who carry a trauma kit have never opened it under stress. They've watched YouTube. They haven't drilled it. The first time they pull the tourniquet out of cellophane is during the worst moment of someone's day.

The Tac-Med Ready Guide closes the gap. 32 pages, written by a Green Beret 18D, designed to be readable in the worst moment. Five home drills that translate trauma doctrine into reflex. A handoff card for EMS. Notes pages after every section.

Get the Tac-Med Ready Guide in paperback ($14.99): buy it on Shopify.

Or get the full Signature Edition 5-book bundle ($64.99): see the series.

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Drive. Shoot. Train. Stop the bleed.

3 Phases. 4 Pillars. 1 Mission.

📕 The Pocket Coach Series Signature Edition Paperback — $14.99 each. See the series.

📚 5-Book Bundle $64.99. Get the bundle.

📱 Free daily training: SOFAST Groundwork (iOS).

🤝 The tribe: Patreon.

"Get to the fight. Finish the fight. Bring everyone home."

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Patch's gear (Amazon)

A few items I actually use. Affiliate links — commissions fund the work, no cost to you.

• CAT Gen 7 Tourniquet (genuine NAR)

• Israeli Emergency Bandage 6 inch

• Streamlight TLR-7A FDE pistol light

• Salomon Speedcross 6 trail runners

• GORUCK GR1 21L Heritage pack

• Black Diamond Storm 450 headlamp

Pocket Coach Series paperback on Amazon — Tac-Med (Book 1) · 5-book bundle on Gumroad — $34.99 digital

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Audiobook — narrated by Patch

The Tac-Med Ready Guide is now an audiobook — 28 minutes in my voice, the same field reference you can hear while you drive, train, or move. $14.99 on Gumroad.

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