e. Apply manual pressure over the pressure dressing while keeping the limb
(1) If the pressure dressing controls the bleeding, proceed to check the
casualty for other injuries.
Check the distal end of wounded extremity (fingers or toes) periodically for
adequate circulation. The pressure dressing must be loosened and
reapplied if the area below the dressing becomes cool, blue, or numb. If
circulation is not restored, evacuate the casualty as soon as possible.
(2) If the wound continues to bleed, apply digital pressure, if possible. If
applying digital pressure is not possible or does not control the bleeding, apply a
tourniquet as described in Section II.
APPLYING DIGITAL PRESSURE
Applying digital pressure to "pressure points" is another method of controlling
bleeding. This method uses pressure from the fingers, thumbs, heel of the hand, or
knee to press at the site or point where a main artery supplying the wounded area lies
near the skin surface or over bone (see figure 5-14). This pressure may help shut off or
slow down the flow of blood from the heart to the wound. It is used in combination with
pressure and elevation. Two pressure points are discussed below.
a. Arm (Brachial Artery). Digital pressure is used to control severe bleeding of
the lower part of the arm and elbow.
(1) The pressure point is located above the elbow on the inside of the arm in
the groove between the muscles.
Using your fingers or thumb, apply pressure to the inside of the arm over
b. Groin (Femoral Artery). Digital pressure is used to control severe bleeding
of the thigh and lower leg.
The pressure point is located on the front, center part of the crease in
(2) Using the heel of your hand or your knee, apply pressure to press the
artery against the bone. Lean forward to apply pressure.