When direct pressure cannot control bleeding, what is the appropriate next step?

• A. Apply a tourniquet or hemostatic dressing as appropriate, continue pressure, monitor signs of shock, seek advanced care.
• B. Only apply more direct pressure.
• C. Ignore the bleeding.
• D. Apply ice directly to the wound.

Answer: (A)

When direct pressure doesn’t stop a bleed, escalate to hemorrhage control that is designed for life-threatening bleeding. Use a tourniquet on a limb if the bleeding remains uncontrolled and you cannot stop it with pressure, or apply a hemostatic dressing to accelerate clotting in areas where a tourniquet isn’t feasible, all while continuing to apply pressure if possible. Seek advanced care immediately and monitor the person for signs of shock (like pale, cool skin, weakness, dizziness, or confusion). Ice directly on the wound should not be used, and the bleeding should not be ignored.