Massive hemorrhage supplies address the first letter of M.A.R.C.H. because uncontrolled bleeding causes death faster than any other trauma, taking a life in minutes while other injuries can wait. Tactical Combat Casualty Care puts hemorrhage control first for that reason, and the equipment in this category, tourniquets, hemostatic dressings, packing gauze, and pressure bandages, represents the interventions with the best-documented record of preventing death before hospital care. Medics, first responders, and trained civilians all build this layer first.

Available options include windlass and elastic tourniquets, hemostatic and compressed gauze for wound packing, and pressure dressings from field-proven brands like North American Rescue, TacMed Solutions, Safeguard Medical, QuikClot, and Celox.

The interventions form a ladder matched to the wound. Extremity bleeds that a tourniquet can reach get a tourniquet, high and tight or per training; junctional wounds at the groin, armpit, and neck get packed with hemostatic or compressed gauze under sustained pressure; and everything gets a pressure dressing over it to hold the work in place. Buying by this logic means carrying all three rungs rather than a drawer of one, and carrying multiples, because real bleeding events consume supplies at a rate that surprises first-timers. Training converts all of it from inventory to capability, and hemorrhage control is the most accessible trauma skill a civilian can learn.

Go deeper in tourniquets and hemostatic gauze, and carry the layer as a unit in an IFAK built around bleeding control.