Prehospital Trauma Life Support (PHTLS) Practice Test

An adult male sustained a deep laceration to his distal thigh. Bright red blood is spurting from the wound. What is the most appropriate next step?

1. Apply a topical hemostatic agent and transport

2. Apply a tourniquet and tighten it until bleeding stops

3. Elevate the leg and apply pressure to the femoral artery

4. Maintain direct pressure and transport immediately

The correct answer is: Apply a tourniquet and tighten it until bleeding stops

In cases of arterial bleeding, which is indicated by bright red, spurting blood, applying a tourniquet is the most effective and appropriate initial intervention. This type of bleeding suggests that the artery has been compromised, requiring immediate action to control the hemorrhage. Using a tourniquet allows for the rapid occlusion of blood flow to the area, preventing further blood loss and reducing the risk of hypovolemic shock. The tourniquet should be placed above the site of bleeding and tightened until the bleeding stops, which provides a strong, direct method to manage the significant vascular injury. While maintaining direct pressure and using hemostatic agents can be beneficial in other scenarios, they may not be sufficient when faced with a life-threatening arterial bleed. Elevating the leg and applying pressure to the femoral artery can provide some support, but this option is less effective and takes more time compared to a tourniquet, making it less suitable for managing such a critical situation.