Despite direct pressure, a large laceration continues to spurt bright red blood. You should:

• A. Place additional dressings on the wound until the bleeding stops.
• B. Apply pressure to the proximal arterial pulse point near the injury.
• C. Elevate the extremity and apply a tight pressure dressing.
• D. Apply a tourniquet proximal to the injury until the bleeding stops.

Answer: (D)

When a large limb laceration spurts bright red blood despite direct pressure, you’re dealing with a high-flow arterial bleed. The fastest, most reliable way to stop that kind of bleeding is to occlude the arterial supply by applying a tourniquet proximal to the injury. A tourniquet creates complete, temporary occlusion of blood flow to the injured limb, which directly halts the spurting and buys time for treatment and transport. Place it high and tight—typically 2 to 3 inches above the wound on bare skin if possible—and keep it in place until the bleeding stops or advanced care arrives. Note the time of application and do not remove it prematurely.

Dressings and elevation help with venous or lighter bleeding, and applying pressure to a proximal pulse point isn’t dependable for stopping a rapid arterial bleed. A tight pressure dressing alone may slow bleeding but won’t reliably stop high-pressure arterial hemorrhage the way a tourniquet does.