A 20-year-old with a severe laceration to the wrist is bleeding heavily. Which action is most appropriate first?

• A. Wrap the towel with pressure bandages.
• B. Administer high-flow supplemental oxygen.
• C. Apply a tourniquet proximal to the wrist.
• D. Apply pressure to the brachial artery.

Answer: (C)

When there is life‑threatening bleeding from an arm, stopping the bleed fast is the priority. In a severe wrist laceration, applying a tourniquet proximal to the wound is the most effective way to stop arterial blood flow and rapidly control hemorrhage. Direct pressure or trying to wrap a towel can help, but heavy bleeding may continue despite pressure, and time is critical—the tourniquet provides definitive control. Trying to compress the brachial artery by hand is unreliable and impractical in a real‑world emergency, whereas a properly placed tourniquet reliably halts the bleeding. Oxygen support is important for overall patient care, but it does not address the bleeding itself. So the best first action is to apply a tourniquet proximal to the wrist.