Massive Hemorrhage First
Current guidelines emphasize controlling life-threatening bleeding before airway management in many scenarios. Apply direct pressure immediately and escalate quickly if bleeding continues. Do not waste time with elevation or pressure points as primary methods.
Tourniquet Use
Place the tourniquet 2 to 3 inches above the wound, not over a joint, and tighten until bleeding stops. Note the time of application and never loosen it in the field. A second tourniquet side by side may be needed if bleeding persists.
Junctional Wounds and Packing
For wounds in the groin, axilla, or neck where tourniquets do not fit, pack the wound with hemostatic gauze and hold firm pressure for at least 3 minutes. Pack deeply into the wound to the bleeding source. Treat for shock and transport rapidly.