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DirtyDocs M.A.R.C.H. Digital Manual
Purpose. This manual explains how to run the digital casualty builder with the physical or virtual M.A.R.C.H. card game. The app presents the casualty, tracks assessments, applies treatment cards, simulates physiology, and supports multiplayer card flow.
0. Searchable Card Compendium
1. Game modes and setup
Physical Card Mode (Coming Soon): this mode is temporarily blocked during alpha while MARCH Mobile is refined.
Virtual Deck Mode: The app tracks the deck, discard pile, player hands, visible evac cards, and turn order for up to 4 players.
Start by entering a callsign, choosing a session number, selecting difficulty, and starting or joining the session.
2. Main tab flow
Scenario: Read the casualty narrative, use Help, and switch between casualty numbers. Scan and Handoff Patient are physical-mode tools and are hidden in Virtual Deck Mode.
Casualty: Inspect the body, use the anterior view, hold Dog Tag, and open body-zone assessment radials. Posterior view is currently marked coming soon.
Cards: Play treatments, medication cards, evacuation cards, marking cards, and special cards. Review deck probabilities where shown.
Vitals Check: Review current vital signs and how treatment decisions are changing the casualty over time.
3. Casualty assessments and body interaction
Press and hold supported body zones to open radial assessment menus. Assessments can reveal bleeding type, breathing findings, airway problems, perfusion clues, skin signs, and other scenario details.
The casualty image uses layered injuries, treatments, uniform, and dog tag overlays. Uniform can be cut away. Distal assessments may be disabled after amputations.
Use the Dog Tag button to view identity and medical reference data. Use the anterior/posterior buttons to inspect both sides of the casualty.
4. Treatment card rules
Play treatment cards in the same order and logic you would use during M.A.R.C.H. The sim rewards correct lifesaving interventions and can penalize inappropriate or delayed treatment.
Most turns allow one card play, then refill back to six cards. Some cards create extra effects, target another player, or stay in the aid bag while active.
Treatments placed on casualties remain tracked on the board and reduce the number of unseen copies left for future card probability calculations.
5. Medication and fluid rules
Medication cards support routes such as PO, ODT, IN, IM, IV, IO, and drip when appropriate.
2026 TCCC update: The medication selector includes suzetrigine in the CWMP, esketamine IN for pain, cefadroxil/cephalexin/ceftriaxone antibiotics, TXA 2 g slow IV/IO push criteria, and hypertonic saline options for suspected herniation.
Medication drips: choose the medication, then choose Route → Drip, then confirm an active crystalloid fluid source. Medication drips cannot be mixed into blood.
Fluids assume 1 L bags unless otherwise shown. Bag statistics track remaining volume, percent full, and running or paused status. Resume Fluid allows the drip rate to be edited before restarting.
Correct and incorrect dosing can change pain control, blood pressure, heart rate, oxygenation, mental status, and other physiology.
6. Evacuation, marking, handoff, and special cards
Air Evac: shared/visible when applicable and may evacuate selected casualties after confirmation.
Ground Evac: resolves through the deck/discard flow based on current rules.
Method of Marking: alpha deck counts use one copy of each marking card, and they can interact with Air Evac availability.
Handoff: trade a casualty or casualty state with another player through the handoff flow.
Complication, Contact!, Tactical Acquisition, MASCAL, Combative Patient, Inclement Weather and other special cards target players or alter the board state and turn flow.
7. Virtual deck mode rules
In Virtual Deck Mode, the app tracks draw pile, discard pile, cards in player hands, visible evac cards, and cards already committed to casualties.
Turn timers, refill rules, target notifications, and acceptance flows are handled digitally. If the draw deck empties, the discard pile is recycled according to the current reshuffle rule while keeping the last visible discard card in place.
Displayed probabilities are based on tracked live card locations, not only the original deck list. Marking cards are tracked as one copy each in the current alpha build.
8. Scan and complication use
The Scan button is for physical-card QR exchange workflows only. Virtual Deck Mode does not use QR flow.
In Virtual Deck Mode, targeted cards resolve through digital target notifications instead of QR scan flow.
9. AAR and training intent
After action review summarizes vitals, interventions, penalties, and outcome trends. Use it to discuss whether treatment order, timing, dosing, or evacuation decisions were appropriate.
This simulator is for training and gameplay support. It is not a replacement for formal medical direction, TCCC instruction, or real-world clinical judgment.
10. Quick reference
Start: make scenario → inspect casualty → assess → treat in M.A.R.C.H. order.
Medication drip: Medication card → select med → Route → Drip → choose active crystalloid → confirm.
Virtual turn: play card → resolve effects → draw/take discard as required → end at exactly 6 cards.
Need more detail? Reopen this manual anytime from the Scenario tab.
Play a Card
Card Preview
Played Treatment Cards
Special Cards in Play
Evac Cards in Play
Action Log
Complication! Scan
Use this tab to scan or create Complication! card QR codes. This tab is not for casualty handoff.
