A patient sustains a severe laceration to the thigh during a motor vehicle collision with brisk arterial bleeding. Despite applying direct pressure and a pressure dressing, the bleeding continues. What is the next best step to manage the hemorrhage?
Apply an ice pack to the wound
Elevate the leg
Apply a tourniquet proximal to the laceration
Administer tranexamic acid (TXA)
The correct approach to manage severe, uncontrolled arterial bleeding is to apply a tourniquet. A tourniquet effectively compresses the surrounding tissue and vessels to stop arterial flow distal to the injury site. Hemostatic agents like TXA (tranexamic acid) are important adjuncts but do not act as rapidly as a properly applied tourniquet. Elevating the leg or applying an ice pack may provide minimal benefit and do not address the severity of arterial hemorrhage effectively.
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