A person who has injured his right arm has heavy external bleeding from the open wound. What should be the first-aid measure to control bleeding?

Appeared in: BTSC 3 August 2025

Explanation

Applying direct, firm pressure is the most effective and immediate first-aid action to control heavy external bleeding.
This action works by physically compressing the damaged blood vessel against underlying structures like bone, which mechanically stops or slows the flow of blood.
Slowing the blood flow allows platelets to aggregate and clotting factors to activate, forming a stable clot to seal the vessel.
Using a clean cloth or bandage helps apply focused pressure and provides a barrier against infection.

Option A: Applying a tourniquet is not the first-aid measure. It is a last resort for severe, life-threatening limb bleeding that cannot be controlled by direct pressure.
Option B: Simply wrapping a bandage without applying firm pressure is ineffective for heavy bleeding. The bandage will quickly become saturated without stopping the blood flow.
Option D: Applying ice is not a primary intervention for controlling heavy bleeding. While it can cause vasoconstriction (narrowing of blood vessels), its effect is insufficient and too slow to manage significant hemorrhage.

Clinical Relevance

Nursing practice connection: Knowing First-aid management of external hemorrhage helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Knowing the correct first step—direct pressure—is a critical life-saving skill for nurses and the general public.
Nurses play a vital role in educating patients, families, and communities on basic first-aid principles, including hemorrhage control.
What if? If bleeding soaks through the initial bandage, the correct action is to add another bandage on top of the first one and continue applying pressure. Do not remove the original dressing, as this can dislodge any clot that has started to form.

How to Approach the Question

First, identify the key clinical problem presented in the question: 'heavy external bleeding' from an 'open wound'.
Recall the standard, evidence-based protocol for first-aid management of hemorrhage. The universally taught first step is to apply direct pressure.
Evaluate each option against this primary principle.
Option C directly describes applying pressure with a clean cloth, which aligns perfectly with the correct first step.
Analyze the other options: A tourniquet is a last resort, a bandage without pressure is ineffective, and ice is for minor swelling, not heavy bleeding.
Conclude that applying direct pressure is the correct initial action.

Concept Tested & Keywords

Concept Tested: First-aid management of external hemorrhage
Stem keywords: injured right arm, heavy external bleeding, open wound, first-aid measure
Lead-in keywords: What should be the first-aid measure
Clinical cues: The cue 'heavy external bleeding' indicates a serious situation requiring immediate and effective action to prevent significant blood loss and shock.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 117-119

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 89-91

Practise the full BTSC 3 August 2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.