Clinical Stop the Bleed® Decision Framework
Inspired by the rapid life-saving tourniquet application in catastrophic limb hemorrhages.
1. Extremity Arterial (Limb)
For limbs (arms/legs) with spurting or non-clotting pooled blood, immediate Combat Application Tourniquet (CAT) is standard of care. Place 2–3 inches above wound (or "high and tight" if wound location is obscured). Turn windlass until bright bleeding stops and distal pulse vanishes.
2. Junctional & Groin Bleeding
Standard limb tourniquets cannot be seated around the groin, pelvis, armpit (axilla), or neck. Immediately pack hemostatic or sterile gauze directly into the cavity to the depth of the severed vessel against bone, then hold uninterrupted manual pressure for at least 3 minutes.
3. Hemodynamics & Time Criticality
A severed femoral artery can discharge 1,500 mL of blood in under 90 seconds, triggering irreversible Class IV hemorrhagic shock. Note exact time on the tourniquet white TIME strap. Never loosen a properly applied tourniquet in the pre-hospital setting.