Trauma
Bleeding Control & Shock Recognition
Hemorrhage management and perfusion assessment grounded in CDC trauma triage and NIH clinical references.
Stopping life-threatening hemorrhage
Uncontrolled bleeding is a leading preventable cause of trauma death. Direct pressure remains the first intervention for most external hemorrhage. When extremity bleeding cannot be controlled, tourniquets—applied high and tight—are appropriate within basic scope and training.
The CDC’s field triage guidance highlights abnormal physiology—including hypotension and poor perfusion—as indicators of severe injury requiring rapid transport to definitive care.1 Controlling bleeding on scene directly affects whether the patient arrives alive.
Understanding shock
Shock is inadequate tissue perfusion. MedlinePlus, a service of the National Library of Medicine, describes how the body compensates early—with tachycardia, anxiety, and cool, pale skin—before blood pressure falls.2 EMTs must recognize compensated shock before decompensation.
Treat causes you can address: hemorrhage, airway failure, tension pneumothorax (recognize and support per scope), and severe allergic reactions. Positioning, warmth, and oxygen support perfusion while minimizing on-scene time.
Circulation in the primary survey
Assess pulses, skin color, temperature, and mental status together. In trauma, expose quietly to find hidden bleeding while preventing hypothermia—a contributor to the lethal triad of acidosis, coagulopathy, and hypothermia in severe injury.
Repeat perfusion checks after every intervention. A patient who “looks better” after tourniquet placement still needs urgent transport and surgical capability.
