Best Initial Intervention

[JorgeAlvarez]

On my Final Medsurg Exam I got a question that had me thinking a little longer than usual. I was wondering if I could get someone else's input on the subject.

The Question Asked Something Like "You are walking through a store and notice an employee broke a glass and received a laceration to the thigh. You notice a large amount of bright red blood coming from the wound. What is the best initial intervention by the first responder?"

A. Elevate the limb above the heart

B. Use a Belt on the upper part of the thigh to apply pressure

C. Place Hand/Fingers near groin area to apply pressure on Femoral Artery

D. Use a shirt to apply pressure on the wound

May I please have your Thought & Rationale?

I believe I went with "C" on the Exam

[NurseGirl525, ASN, RN]

To me, it depends on how that blood is coming out. Is it squirting out? That indicates that the blood is coming from the artery. If it's just bleeding, I apply pressure to the wound. Since the question did not describe the bleeding as squirting, I would say D. The question is trying to get at whether or not you know if a wound is from the artery or vein and how you would take care of it. With out the key word squirting, I would think it's a regular wound.

[Wuzzie]

The correct order to stop bleeding in a first responder scenario is:

1. Direct pressure

2. Elevation

3. Pressure point (arterial)

4. Tourniquet

[That Guy, BSN, RN, EMT-B]

You are going to have a lot of questions to answer on why you didn't go to direct pressure and firmly went to the employees groin. Rarely does direct pressure and elevation not work.

[KRVRN, BSN, RN]

Unless the person is supine and still you will waste time trying to get to the artery. Pressure to wound first.

[eerlijke]

I am starting nursing school in the fall and right now I am trained as a paramedic. always try direct pressure first to see if that controls the bleeding. where I live we are moving away from pressure points all together (they weren't taught at all in my EMR course) and we're taught that if direct pressure doesn't work to go straight to a tourniquet. this change is coming because they're finding that pressure points are difficult and not very effective, and tourniquets aren't as dangerous as people used to think (ei. there's still adequate perfusion to a distal limb for probably up to 8h without ever releasing the tourniquet, even though that's not what we do if we follow our treatment guidelines)

[KatieMI, BSN, MSN, RN]

Direct pressure first, because it only takes a second to do. Everything else rolling out as you yell for help while holding that pressure. Elevation above heart is cumbersome and kinda useless.