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Limb arterial haemorrhage — DIPIMC MCQ

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ModeratePre-Hospital TraumaLimb arterial haemorrhageDIPIMCDipIMC

A worker has sustained a deep laceration to the forearm from machinery, with bright red blood spurting from the wound. Firm direct pressure applied for several minutes has not stopped the bleeding and the dressing is rapidly soaked. What is the most appropriate immediate action?

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

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Correct answer: C — Apply an arterial tourniquet proximal to the wound and record the time of application

When direct pressure fails to control arterial limb haemorrhage, a windlass or pneumatic tourniquet placed proximal to the wound and tightened until bleeding stops is indicated, with the application time clearly recorded. Adding dressings or intermittently releasing the tourniquet allows ongoing blood loss. Repeatedly inspecting the wound disrupts clot formation, and distal cannulation does not address the bleeding. Pearl: a correctly applied tourniquet may remain in place for the duration of a typical pre-hospital transfer.

Reference: JRCALC Clinical Guidelines