What is a recommended action if direct pressure cannot control life-threatening bleeding and EMS is not immediately available?

• A. Elevate limb
• B. Apply a tourniquet as a last resort
• C. Apply direct pressure with a dressing
• D. Call EMS and wait

Answer: (B)

When external bleeding is life-threatening, the priority is to stop the flow of blood as quickly as possible. If you’ve tried direct pressure with a dressing and it can’t control the bleed, and EMS isn’t immediately available, a tourniquet becomes the next option to save life, but only as a last resort for bleeding from a limb. A tourniquet can effectively stop heavy blood loss when applied correctly, whereas continuing with pressure alone may not be enough and waiting for help could be fatal.

To use a tourniquet correctly: place it around the limb between the wound and the body, as high as needed but not over a joint, using a wide band if available. Tighten until the bleeding stops and you can no longer feel a pulse distal to the tourniquet. Secure it in place with a windlass, strap, or tight knot, and note the time of application. Do not remove it once applied, and seek advanced medical care as soon as possible. If another tourniquet becomes necessary, place it proximal to the first one, again above the wound, and secure and time it.