The First 90 Seconds of a Civilian Bleeding Emergency
- May 18
- 2 min read
Updated: 5 days ago
The First 90 Seconds of a Civilian Bleeding Emergency
You're at a Friday night football game. The man two rows down clutches his thigh and pitches forward. Blood is on the bleachers before anyone has reached him.
What you do in the next 90 seconds matters more than every minute that follows.
The frame: MARCH-PAWS, civilian version
Combat medics use MARCH-PAWS as their first-look priority list — Massive hemorrhage, Airway, Respirations, Circulation, Hypothermia, then Pain, Antibiotics, Wounds, Splinting. The Committee on Tactical Combat Casualty Care has validated the order for over two decades because it maps the order injuries actually kill.
For a civilian on bleachers, the first letter is the only one you need to internalize. Stop the bleeding that's killing him right now. Everything else can wait two minutes.
A femoral artery bleed exsanguinates in roughly three to five minutes. Ambulance arrival in most US suburbs is eight to twelve minutes. The math is the entire reason you exist in this story.
The drill — what you do today
Look for the blood. Bright red, pulsing, soaking through clothing in seconds = arterial. That's your priority.
Direct pressure first. Both hands, full body weight, into the wound. Most bleeds stop here. Most are not on a limb.
If it's on a limb and pressure isn't holding it: tourniquet, high and tight. Two to three inches above the wound, no joint between. Crank until the bleeding stops. It will hurt. Continue.
Mark the time of application. Write it on his forehead with a pen if you have to. Hospital staff need to know.
Stay with him. Hand him your phone. Tell him to call his mother.
Steps 1-3 take about 45 seconds with practice. Practice happens before you need it, not during.
The shortcut
The detailed version of this — including the 3-test counterfeit tourniquet check, the IFAK contents list, and the pediatric variations — is in the Tac-Med Ready Guide, Volume 1 of the Pocket Coach Series. Twelve pages. Fits in your back pocket. $9.99 — also on Gumroad and coming soon to Amazon Kindle.
Bundle the full 5-book set for $34.99 and save 30%.
Educational use only. Does not replace certified Stop The Bleed training (find one near you at [stopthebleed.org](https://www.stopthebleed.org)). Adapt every recommendation to your local laws, climate, and household.
Patch's gear (Amazon)
A few items I actually use. Affiliate links — commissions fund the work, no cost to you.
Pocket Coach Series paperback on Amazon — Tac-Med (Book 1) · 5-book bundle on Gumroad — $34.99 digital
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.
SOFAST Groundwork — Free App
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