A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

• A. Elevate his legs and keep him warm.
• B. apply direct pressure to the wound.
• C. Ensure that his airway is patent.
• D. Administer 100% supplemental oxygen.

Answer: (B)

Controlling external bleeding is the immediate priority when there’s a penetrating groin injury with bright red, spurting blood. That pattern signals an arterial bleed, which can rapidly cause life-threatening blood loss. The best first action is to apply direct pressure to the wound with a clean dressing, pressing firmly to tamponade the injured vessels. This direct pressure physically compresses the broken vessels and slows or stops the bleed, buying crucial time for further care.

After applying direct pressure, keep pressure on the wound and monitor the patient, ready to add more dressings or escalate to wound packing or a tourniquet if bleeding persists per protocol. Airway and breathing are important, and high-flow oxygen may be needed, but they don’t control the hemorrhage as quickly as direct pressure in this scenario. Elevating the legs isn’t beneficial for active groin bleeding, since the priority is stopping the blood loss.