Key Principles

• Control the bleed before anything else
• Keep pressure and reassess
• Stay aggressive and do not quit

When To Use This

• You have no tourniquet
• Wound sits high near the armpit junction
• A tourniquet cannot stop the bleeding

If A Tourniquet Exists

• Apply it high and tight on the upper arm
• Use pack and pressure for junctional wounds
• Default to the tourniquet when available

What You Can Use

• Reach first for hemostatic gauze
• Fall back to rolled gauze or clean cloth
• Improvise with belt, ACE wrap, or plastic

Assess And Expose

• Check where you are hit
• Cut or tear clothing away
• Ready your hands for immediate pressure

Apply Direct Pressure

• Press hard with your palm on the wound
• Use gauze or hemostatic gauze
• Hold while preparing to pack

Pack The Wound

• Push gauze deep into the wound cavity
• Pack tight against the bleeding source
• Never remove gauze once packed

Hold And Reassess

• Press palm over the packed wound
• Hold steady for at least three minutes
• Reassess, then get to help