After applying direct pressure and a hemostatic agent, what is the next step to control bleeding on an extremity?

• A. Elevate the limb and reassess
• B. Apply a tourniquet if bleeding persists or is life-threatening
• C. Apply a second hemostatic dressing
• D. Check for distal pulse

Answer: (B)

When bleeding from an extremity remains uncontrolled after direct pressure and a hemostatic agent, the next step is to apply a tourniquet proximal to the wound. A tourniquet stops arterial inflow to the injured area, which is the fastest and most reliable way to halt life-threatening external bleeding when dressings alone aren’t enough. Place it high on the limb, tighten firmly until the bleeding stops, secure it, and note the time of application. Don’t loosen it until medical care is available. After it’s on, reassess distal perfusion and continue monitoring for shock while arranging advanced help. Elevation and checking distal pulses are useful in ongoing care, but they don’t replace the need to control severe bleeding with a tourniquet when pressure and dressings fail.