You respond to a shooting at a local bar. A patient with bright red blood spurting from a wound near his groin should:

• A. Ensure an open airway.
• B. Transport the patient at once.
• C. Administer high-flow oxygen.
• D. Apply pressure to the wound.

Answer: (D)

A spurting, bright red bleed from a groin wound means a potential arterial hemorrhage. The most urgent action is to stop the bleeding, since massive arterial loss can quickly lead to shock and death. The best initial step is to apply direct pressure with a clean dressing and maintain it until the bleeding slows or stops. Airway and breathing are important, and oxygen can be given if needed, but they do not address the immediate life-threatening bleeding in this moment. If bleeding continues despite pressure, escalate to additional hemostatic methods or a tourniquet as appropriate, but stopping the bleed first is the priority.