What is the first step in controlling massive hemorrhage?

The first step in controlling massive hemorrhage is to apply a tourniquet or direct pressure to the wound. This immediate action is crucial in preventing further blood loss and ensuring the survival of the casualty.

When a person suffers from a traumatic injury leading to significant bleeding, the body has limited time before the loss of blood becomes critical. Applying a tourniquet effectively occludes blood flow to the affected limb, allowing for rapid control of hemorrhage. Direct pressure on a wound can also be beneficial in slowing or stopping the bleeding, particularly in the case of non-extremity injuries or where a tourniquet cannot be applied.

Other options, while potentially beneficial in the broader context of managing trauma, are not prioritized for immediate hemorrhage control. Administering intravenous fluids typically occurs after bleeding has been controlled, as fluid resuscitation does not address the source of blood loss. Positioning the casualty supine or elevating the wound may provide some benefit in specific situations but are not prompt life-saving measures like applying a tourniquet or direct pressure. These actions should occur swiftly, ideally right at the point of injury, to maximize the chances of survival before more advanced care can be delivered.