What is the most appropriate initial management for an avulsion of the foreskin with moderate bleeding?

• A. Administer pain medication.
• B. Provide 100% oxygen.
• C. Apply direct pressure with a dry dressing.
• D. Apply moist sterile dressings.

Answer: (C)

Controlling bleeding takes priority. The most effective first step is to apply firm direct pressure to the avulsed foreskin with a clean, dry dressing. This direct pressure compresses the bleeding vessels and promotes clot formation, rapidly reducing moderate bleeding. A dry dressing helps maintain a dry environment, which supports hemostasis and lowers infection risk.

Pain relief and oxygen aren’t the immediate actions needed to stop the bleeding, and a moist sterile dressing isn’t as reliable for achieving rapid hemostasis in this scenario. After bleeding is controlled, seek medical evaluation for wound care, potential repair, and tetanus status as needed.