Prehospital Trauma Life Support (PHTLS) Practice Test

What is the most appropriate initial action for a deep laceration with significant bleeding?

1. Apply a tourniquet

2. Apply direct pressure

3. Initiate rapid transport

4. Restore blood volume

The correct answer is: Apply direct pressure

Applying direct pressure to a deep laceration with significant bleeding is the most appropriate initial action. This method addresses the primary goal of controlling bleeding effectively. Direct pressure helps to compress the blood vessels at the site of the injury, which can significantly reduce blood loss. It is a fundamental technique taught in trauma care, emphasizing that controlling hemorrhage is a crucial step before considering further interventions. This approach should be applied immediately while assessing the patient's overall condition, which may include checking responsiveness, airway, breathing, and circulation. If direct pressure is not successful in controlling the bleeding within a reasonable time, other measures like a tourniquet can be considered, especially for limbs. However, initiating rapid transport or restoring blood volume can be critical in managing trauma patients, those actions are typically secondary to and contingent upon the effective control of bleeding at the source. Thus, starting with direct pressure is a foundational principle in trauma management.