In managing a large avulsion, what is the immediate priority?

• A. Cleaning the wound.
• B. Controlling external bleeding.
• C. Assessing distal circulation.
• D. Immobilizing the injured area.

Answer: (B)

Controlling external bleeding is the immediate priority because life-threatening hemorrhage from a large avulsion can lead to rapid blood loss and shock. The first action is to apply direct pressure with a sterile dressing to stop the bleeding, and escalate to a tourniquet only if direct pressure cannot control it. This focus on hemorrhage control comes before cleaning the wound, assessing distal circulation, or immobilizing the area. Once the bleeding is under control, you can move on to cleaning and dressing the wound, checking distal circulation, and immobilizing the injured part as needed.