The Safe Marche Ryan protocol is an effective method of tactical first aid, designed to intervene in serious emergencies, particularly in military or crisis contexts. It provides a structured framework for quickly treating an injured victim, prioritizing massive hemorrhages through tools such as the tourniquet or the compression bandage, while ensuring a secure evacuation.

This protocol is based on three key steps: SAFE to secure the area and eliminate threats, MARCHE to treat life-threatening conditions such as hemorrhages and respiratory problems, and RYAN for continuous reassessment, including prevention of shock and hypothermia.

Adopted by recognized institutions such as the HIA Desgenettes and the CITERA Lyon, this protocol is essential for any professional or volunteer working in a hostile environment. Mastering these steps ensures rapid intervention and reduces errors in extreme conditions.

Understand the Safe Walk Ryan protocol.

Origin and need for the protocol

The Safe Marche Ryan protocol was originally designed in a military context to meet the specific needs of tactical first aid on the battlefield. Derived from Tactical Combat Casualty Care (TCCC) developed in the 1990s, it aims to structure the management of casualties in hostile environments where the safety of the rescuer may be compromised. Its main objective is to reduce preventable mortality by providing responders with a clear, hierarchical, and mnemonic guide for essential emergency procedures.

This protocol was subsequently adapted to the civilian environment in the form of TECC (Tactical Emergency Casualty Care). This demonstrates its relevance in all crisis situations, particularly during the evacuation of a seriously injured victim.

Composition and steps of the protocol

The Safe Marche Ryan protocol is structured in three complementary phases, each represented by an acronym that guides the actions to be taken:

SAFE is the first step. It focuses on securing the area and the initial assessment in order to neutralize any immediate threat that could compromise care.

MARCHE defines the priorities for intervention on the injured person. This phase emphasizes critical points such as the control of massive hemorrhages, the management of breathing, and the prevention of shock. Each action is designed to maximize the chances of survival in an emergency context.

This methodical approach optimizes the use of resources and equipment, such as the tourniquet or bandage, while increasing the chances of survival.

The "SAFE" component: Securing and initial assessment

Stop the burning process / Supprimer la menace

The first step in the SAFE protocol, "Stop the burning process", is to eliminate or neutralize any immediate threat present at the scene of the incident. This involves stopping what directly endangers the victim, but also the rescuer. This phase may include responding to an attack or quickly sheltering the injured and responders to prevent the situation from worsening.

Without this prior securing, no effective care of the injured person is possible.

Access the scene / Assess the situation

Once the area has been secured, it is essential to assess the scene. This includes identifying the number of casualties, residual hazards and the nature of any trauma sustained. This observation enables actions to be prioritized, the necessary equipment to be organized, and preparations to be made for a possible move using the "pick and run" method, which involves rapidly moving the victim away from danger and into a safer environment.

Free of danger for you / Being out of danger yourself

To ensure optimal care, the rescuer must ensure that they are personally out of danger. This involves assessing their own environment and taking all necessary precautions to avoid injury. By remaining safe, the rescuer can intervene with composure and effectiveness, without compromising the rescue mission.

Evaluate the casualties / Évaluer les blessés

The final phase of SAFE is casualty assessment. This rapid assessment enables the most serious cases to be identified and an initial triage to be carried out. It includes :

• Checking the state of consciousness.
• Detection of visible or massive bleeding.
• The recognition of signs of airway obstruction.

This step is essential to determine the priorities of medical intervention before moving on to the MARCH phase.

The "MARCHE" component: Urgent intervention

Massive Bleeding

The first priority in the MARCH component is the control of massive hemorrhage. Rapid blood loss is the leading cause of preventable mortality in the field. To stop the bleeding, a tourniquet or an appropriate compression bandage should be applied immediately. These actions must be performed with rigor and efficiency, as any delay or insufficient treatment can lead to irreversible hemorrhagic shock.

Airways

Once the bleeding has been brought under control, it is imperative to pay attention to the victim's airway. The rescuer must ensure that the airway is clear, and intervene with simple maneuvers such as clearing the airway or placing the victim in the lateral safety position. Delay at this stage can seriously compromise breathing and lead to rapid hypoxia.

Breathing and circulation

After securing the airways, it is essential to assess breathing and blood circulation. Any respiratory distress or circulatory failure must be detected and treated quickly. The protocol emphasizes the importance of preventing shock by maintaining the victim's perfusion and respiratory function. This helps limit complications and facilitate stabilization.

Shock: radial pulse check

To detect the risk of shock, the rescuer must check for the presence of the radial pulse. The absence or weakness of this pulse indicates inadequate blood perfusion, requiring urgent care and appropriate treatment. This check is a key indicator for assessing the severity of the injured person's hemodynamic status.

Head Injury / Traumatic brain injury and hypothermia

It is essential to check for head trauma or signs of hypothermia, as both complications are common and potentially fatal. Management of head trauma relies on rigorous neurological monitoring and appropriate stabilization. As for the prevention of hypothermia, it requires appropriate thermal protection, in order not to further compromise the victim's prognosis.

Everything else / Evacuation and everything else

Once vital priorities have been addressed, the rescuer must organize theevacuation of the casualty, ensuring that secondary injuries are secured and stabilized, even if they are not immediately lethal. This step is essential to optimize subsequent medical care during transfer to a specialized center, such as the HIA Desgenettes Lyon or CITERA Lyon.

Each additional action performed aims to maintain the stability of the injured person while awaiting the arrival of advanced care.

The "RYAN" component: Reassessment and advanced care

Reassess the patient

The RYAN component represents an essential stage of reassessment following the initial interventions performed under the MARCHE protocol. This phase involves methodically examining each point addressed to ensure the effectiveness of the actions taken, such as maintaining or adjusting tourniquets and bandages. It also allows for the detection of any potential worsening of injuries and adaptation of care accordingly, while preparing the victim for safe evacuation.

Eyes and specific treatments

During this stage, a thorough examination of the eyes and neurological system is recommended to identify any lesions that may have gone unnoticed during the initial assessment, particularly in cases of traumatic brain injury. This rapid neurological assessment includes evaluating pupillary response and level of consciousness, guiding towards specific treatments or enhanced medical monitoring if necessary.

Analgesics and pain management

Pain management is an integral part of advanced care. Administering analgesics, when possible and appropriate, is essential to improve the comfort of the injured while reducing their stress level. Particular attention is paid to avoiding any aggravation of the patient's condition, favoring methods compatible with existing trauma.

Clean wounds and prevent infections

Wound cleaning is an essential step to prevent any risk of infection. Although tactical first aid takes into account the sometimes-difficult conditions, it emphasizes the importance of rigorous antisepsis and the use of sterile bandages. This approach helps reduce post-traumatic complications and preserve the victim's functional prognosis until transfer to a specialized hospital center.

Conclusion

The Safe Marche Ryan protocol is an essential tool for effective intervention in emergency situations. It combines tactical first aid, the SAFE protocol for securing the area, MARCHE for managing life-threatening emergencies, and RYAN for advanced care and reassessment. Mastering these steps is essential to saving lives, while optimizing the use of equipment and techniques, such as the tourniquet or the management of massive hemorrhages. We strongly encourage you to train today to be ready to intervene quickly and effectively in critical situations.

FAQ

How does the Safe March Ryan method help save lives, and what are the first aid steps and procedures taught?

Safe Marche Ryan helps save lives by emphasizing priority first aid procedures, particularly in military or extreme situations. Here are the milestones:

• SAFE: secure the area to avoid any immediate danger.
• MARCHE: treat critical injuries according to their severity, including massive hemorrhages, breathing problems, shock, and hypothermia.
• RYAN: manage less urgent secondary injuries while preparing for evacuation.

These actions, performed quickly and efficiently, maximize the chances of survival in hostile situations or those involving multiple victims.

Who can take the Safe Marche Ryan course and what are the prerequisites?

Safe Marche Ryan training is primarily aimed at military personnel, as it is an integral part of their initial combat rescue training. It is designed to teach the first aid gestures necessary in extreme conditions, in order to protect and quickly take care of an injured person in the field.

No specific prerequisites are mentioned, other than being confronted with military situations requiring these skills.

How long does Safe Marche Ryan training last and does it lead to recognized certification?

Safe Marche Ryan training is included in the initial training program of the military health service. However, its precise duration is not specified in the available sources.

It confers recognized competence in the field of tactical first aid, particularly in the military environment. However, it is not indicated that it leads to an official civilian certification.