A 22-year-old woman who was shot is conscious but extremely restless, pale, and diaphoretic. As your partner administers high-flow oxygen, you should:

• A. Compare carotid and radial pulses
• B. Take BP to detect hypotension
• C. Keep warm by blankets
• D. Look for and control any bleeding

Answer: (D)

The priority concept is that stopping life-threatening external bleeding takes precedence in a penetrating trauma with signs of shock. The patient’s restlessness, pallor, and diaphoresis indicate ongoing blood loss and compromised perfusion. While high-flow oxygen supports oxygen delivery, it cannot compensate for significant hemorrhage. The most important action is to identify and control any bleeding right away—apply direct pressure to wounds, use a tourniquet for severe extremity bleeding if needed, or pack wounds with hemostatic dressings. Once bleeding is controlled, you can proceed with other tasks (assessing pulses, checking blood pressure, or keeping her warm), but those steps should wait until the bleeding is addressed.