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Junctional haemorrhage — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementJunctional haemorrhageDipIMC

A 29-year-old man has a deep groin wound after broken glass injury. Direct pressure reduces but does not stop bright red bleeding; a standard limb tourniquet cannot be applied effectively. 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 — Pack the wound with haemostatic gauze and maintain firm direct pressure

Junctional haemorrhage that is not amenable to tourniquet control should be treated with haemostatic packing and sustained direct pressure. A loose tourniquet does not control arterial bleeding and may increase venous congestion. Wound irrigation delays haemorrhage control and may disrupt clot formation. The pearl is that groin, axillary and neck bleeding require packing skills rather than standard limb-tourniquet thinking.

Reference: JRCALC Guidelines 2025; ATACC