What is the recommended initial approach to uncontrolled external bleeding on a flight?

• A. Apply direct pressure with a clean dressing, elevate the area if possible, and seek medical help if bleeding continues.
• B. Apply a tourniquet immediately and do not remove it.
• C. Cool the wound with ice and hold it below heart.
• D. Remove the dressing to inspect the wound repeatedly.

Answer: (A)

Direct pressure to control bleeding is the first priority when you’re faced with uncontrolled external bleeding. Press firmly on the wound with a clean dressing or cloth to mechanically compress the blood vessels, helping the clot form and quickly limit blood loss. If possible, elevate the injured part above heart level to reduce the flow of blood to the area and support quicker hemostasis.

Keep applying pressure and add more dressings if the first one becomes soaked. Do not remove the dressing to look at the wound too soon, because lifting or disturbing the clot can restart or worsen the bleeding. If the bleeding continues after several minutes of steady pressure, seek medical help—on a flight, alert the crew so the passenger can receive further assessment or additional care from medical personnel if available.

Other approaches aren’t the best first step. A tourniquet is a life-saving option only when direct pressure cannot control life-threatening bleeding from a limb, and it’s not the initial action. Cooling with ice and holding the limb below heart isn’t an effective method for stopping active bleeding and can cause tissue damage. Repeatedly removing dressings to inspect the wound disrupts clot formation and can provoke more bleeding.