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Axillary junctional haemorrhage — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementAxillary junctional haemorrhageDipIMC

A 37-year-old man has a deep axillary laceration from a circular saw. Bleeding is brisk, not controlled by a pressure dressing, and limb tourniquet placement is anatomically difficult. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Use haemostatic wound packing with sustained pressure while arranging rapid transfer

Axillary bleeding is junctional haemorrhage, often not controlled by standard limb tourniquets. Haemostatic packing with direct pressure is the appropriate immediate measure. Blind clamping risks nerve and vessel injury and delays effective compression. The pearl is that responders should practise packing deep wounds because direct pressure over skin may not reach the bleeding vessel.

Reference: JRCALC Guidelines 2025; ATACC