The 12 C's of Survival Series: Casualty Care/First Aid

Casualty Care: Why First Aid Skills Matter in Survival

In this installment of the 12 C’s of Survival, we’re shifting our focus to one of the most critical categories—Casualty Care. Outside of the basic life-sustaining needs like water, calories, and shelter, few things are more important during an emergency than the ability to treat injuries and manage medical situations until help arrives.

Many accidental deaths in the United States are preventable with basic training and the right equipment. Simply calling 911 and waiting for someone else to show up is not preparedness. Real preparedness comes from knowledge, practice, and the right tools.

Skill + Equipment: The Foundation of Casualty Care

Proper first-aid preparedness isn’t achieved by buying a “1,000-piece” kit from a grocery store and tossing it in your vehicle or pack. Most of those kits consist of 900 band-aids and 100 alcohol wipes—fine for minor cuts, but useless for genuine emergencies.

Some people recognize this and upgrade to a more complete kit: tourniquets, gauze, chest seals, and hemostatic dressings. That’s a great step—but many individuals lack the training to use these items correctly. In that case, the gear becomes nothing more than expensive decoration until someone trained arrives.

To be effective, you need both:

• A thoughtfully selected, purpose-built first-aid/trauma kit

• The training and confidence to use it

ABCDE vs MARCH: Two Paths, One Purpose

Depending on your training background—or the background of your instructor—you will likely learn one of two primary assessment frameworks:

ABCDE Method (Common in EMS)

• A – Airway

• B – Breathing

• C – Circulation

• D – Disability/Decision

• E – Expose/Exposure

MARCH Algorithm (Common in Tactical Medicine)

• M – Massive Hemorrhage

• A – Airway

• R – Respiration

• C – Circulation

• H – Head Injury / Hypothermia

Both systems guide responders through identifying and treating immediate life threats. The main difference is priority:

• MARCH addresses massive bleeding first because uncontrolled hemorrhage kills fast in combat and high-risk situations.

• ABCDE focuses on airway first, in line with EMS protocols.

Regardless of which framework you prefer, the gear you’ll need is essentially the same.

The 5 B’s: Managing Secondary Issues

For follow-on care and less urgent problems, another simple acronym is often used:

• Breathing

• Bleeding

• Breaks

• Burns

• Bites & Stings

These categories help guide treatment once immediate life threats have been addressed.

Gear: Baseline Items for Effective Casualty Care

Below are practical, realistic gear recommendations based on skill level and common civilian use. This is not an exhaustive list, but a strong foundation.

Airway

At the basic civilian level, your primary tools are manual airway maneuvers:

• Head-tilt / chin-lift

• Jaw thrust (for suspected spinal

  injuries)

For those with approved training, you may include:

• Nasopharyngeal airways (NPAs) – require sizing and proper insertion

• Oropharyngeal airways (OPAs) – more training required to avoid harm

Airway tools should only be used by individuals who know how to use them properly.

Breathing / Respiration

Basic, essential items include:

• CPR pocket mask / face shield

• Chest seals (for penetrating chest trauma such as a sucking chest wound)

With additional training (e.g., BLS certification):

• Bag-Valve Mask (BVM) for assisted ventilations

These tools help maintain oxygenation and manage life-threatening respiratory compromise.

Circulation / Massive Hemorrhage / Bleeding

Here the goal is simple: stop the bleed and prevent shock.

Recommended items:

• Tourniquets (windlass-style)

  • CAT-7

  • SOF-T

    • Avoid knockoffs.

• Hemostatic gauze (e.g., QuikClot or Celox)

• Compressed or Z-fold gauze for wound packing

  • Do NOT rely on tampons — they are not effective for trauma wound packing.

• Pressure dressings

  • Israeli bandage

  • H&H bandage

• Assorted adhesive bandages for minor cuts

• Mylar blanket + insulating pad to prevent hypothermia (a major shock factor)

Massive bleeding is one of the most preventable causes of death—good gear and good training save lives.

Disability / Head Injury / Breaks

Depending on the injury, recommended gear may include:

• C-collar or materials to improvise one

• SAM splint or other splinting materials for fractures

• ACE wraps

• Trauma shears (also used for exposure)

These items help stabilize injuries until higher-level care is available.

Expose / Exposure / Burns

Exposure involves both revealing injuries and preventing heat loss or gain.

Essential items:

• Trauma shears (to safely expose wounds without causing further harm)

• Mylar blanket, sleeping pad, or extra clothing (to prevent hypothermia)

• Tarp or shade (for heat protection)

• Burn dressings

  
  

Burns require gentle handling and sterile coverage to prevent infection.

Bites & Stings

Basic items include:

• Sting wipes / afterbite cream

• Antihistamines (when appropriate)

• Epinephrine auto-injector (if medically indicated and authorized)

Allergic reactions can escalate quickly—proper gear and training matter.

Training: The Most Important Part of Casualty Care

Some medical gear requires training—not just for legal reasons, but to avoid causing additional harm. It isn’t enough to buy a trauma kit; you must know how to use it.

Examples:

• Tourniquets must be applied correctly and tight enough

• NPAs/OPAs require knowledge of airway anatomy

• Chest seals must be placed properly to avoid trapping air

• Wound packing requires technique, depth, and pressure

• BVM use requires training to avoid gastric inflation

Training > Gear, every time.

Invest in:

• CPR/AED/First Aid classes

• Stop the Bleed

• Wilderness First Aid (WFA)

• Basic Life Support (BLS)

• Advanced First Aid or Tactical Casualty Care

Practice builds confidence, and confidence saves lives.

What’s Next?

In a follow-up post, I’ll be breaking down the MARCH/ABCDE protocols in much greater detail. We’ll explore the why behind the steps, the how of the human body’s response to trauma, and the practical actions you can take as a prepared responder.