Emergency Medical Technician (EMT) Intermediate Practice Exam

What should you do prior to applying a tourniquet to a profusely bleeding injury?

1. Apply a cold compress to the wound

2. Hold direct pressure over the bleeding site

3. Elevate the injured limb above the heart

4. Clean the wound with saline

The correct answer is: Hold direct pressure over the bleeding site

In managing a profusely bleeding injury, it is essential to apply direct pressure over the bleeding site prior to any other interventions, including the application of a tourniquet. Applying direct pressure helps to control the bleeding by promoting clot formation and slowing down blood loss. This initial step is crucial because it can stabilize the situation before escalating to more invasive techniques like a tourniquet application. While elevating the injured limb above the heart is generally recommended for some types of bleeding, it may not be effective in cases with severe hemorrhaging or if it causes further pain or injury. Additionally, using a cold compress can temporarily constrict blood vessels, but it is not as effective as applying direct pressure and would not sufficiently manage life-threatening bleeding. Cleaning the wound with saline is not appropriate at this stage because the priority is to control bleeding rather than clean the injury. Thus, holding direct pressure over the bleeding site serves as the most immediate and effective approach to mitigate severe blood loss before progressing to other methods like a tourniquet, which should only be used when direct pressure fails to control the bleed.