A traumatic leg amputation below the knee with profuse bleeding and unresponsiveness. How should you control the bleeding?

• A. Locate the femoral artery and apply pressure to it until the bleeding stops.
• B. Apply a pressure dressing and elevate the injured extremity at least 12 inches.
• C. Apply an icepack to the wound to constrict the vessels and stop the bleeding.
• D. Cover the wound with a trauma dressing and apply a proximal tourniquet.

Answer: (D)

The priority is rapid control of life-threatening limb hemorrhage. Proximal tourniquet application directly stops arterial inflow to the injured area, which is essential when bleeding is profuse and unresponsive patients are involved. Covering the wound with a trauma dressing helps prevent contamination and allows you to manage the bleeding more effectively, but clothing or dressings alone won’t reliably stop high-pressure arterial bleeding from a traumatic amputation. Elevation and cold therapy are not reliable methods for stopping severe arterial bleeding in this scenario; they may help with less severe or venous bleeds, but they don’t provide immediate hemorrhage control like a proximal tourniquet does. So, the best approach is to cover the wound and apply a tourniquet proximal to the injury to halt the bleeding, while continuing to monitor the patient and reassess the situation.