A TIERED MARCH FRAMEWORK FOR NON-MEDICAL PUBLIC SECURITY AGENTS RESPONDING TO FIREARM CASUALTIES: A COMPETENCY-BOUNDED PROTOCOL PROPOSAL

In most civilian firearm incidents the first person to reach the victim is a public security agent without medical training, who occupies the critical interval before the arrival of pre-hospital emergency services. In Brazil, where firearms account for roughly three-quarters of intentional violent deaths, this interval frequently determines survival. This article proposes a tiered adaptation of the MARCH protocol (Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia), drawn from the Tactical Combat Casualty Care framework, designed specifically for non-medical security personnel operating in high-violence urban environments. The proposal is conceptual rather than empirical. It does not report a controlled trial or measured patient outcomes. Its contribution is a decision architecture that separates a basic sequence, executable by any trained agent within legal and clinical limits, from an advanced sequence restricted to health professionals and certified tactical responders. Each step carries an explicit competency boundary and a binary decision gate intended to prevent both inaction and overreach. The framework occupies a defined position between layperson hemorrhage-control initiatives and full clinical trauma courses. It is grounded in the international TCCC literature and in field training experience accumulated in Brazil, and it is structured to be transferable to any jurisdiction facing high rates of penetrating trauma and variable emergency response times. The article argues that the tiered logic, rather than the mnemonic itself, is the element that makes battlefield-derived trauma care safely deployable by non-medical first responders within bounded and legally defensible limits.