You arrive at the scene of a gunshot victim with optimal breathing. What is the first step in treating this patient?

When treating a gunshot victim with optimal breathing, controlling bleeding is a critical priority. The correct approach begins with attempting to control the bleeding using a bulky dressing. This method allows for effective management of hemorrhage from the injury site. A bulky dressing provides sufficient pressure to the wound, helping to minimize blood loss while ensuring that the patient's airway and breathing remain unaffected.

Applying direct pressure is also an effective method for controlling bleeding, but utilizing a bulky dressing is typically a more comprehensive initial step, especially if the wound is extensive. In situations involving severe trauma, securing a bulky dressing helps to stabilize the site and prevent further blood loss during transport.

While holding pressure and raising the patient's arm could assist with bleeding control, it may not be sufficient for a gunshot wound, which often requires more robust management. The immediate application of a tourniquet may be appropriate in life-threatening hemorrhages from extremities, but in this scenario, the first step is more appropriately controlling bleeding with a bulky dressing to ensure the patient's safety and stability during subsequent care.