Your patient has a laceration to the right leg that has intersected the femoral artery. After applying direct pressure, what should you do next?

In the scenario described where a patient has a laceration to the right leg that has intersected the femoral artery, immediate and effective management of the injury is critical to prevent significant blood loss.

The step that is most appropriate after applying direct pressure is to apply a tourniquet. While elevating the leg may provide some theoretical benefit in reducing blood flow to the wound, it is not a definitive measure in cases of severe bleeding, especially from an arterial injury. Elevation is not effective in situations where pressure has already failed to control significant hemorrhage, like a femoral artery injury. Instead, a tourniquet is specifically designed to control life-threatening bleeding by occluding blood flow to the limb above the site of injury.

Applying pressure above the injury is a suitable action as well, but it is not the first action to take once direct pressure has been applied. In critical cases such as this, moving to a more definitive control method, like a tourniquet, is vital.

Thus, in line with standard trauma protocol, the most effective next step after applying direct pressure for significant arterial bleeding is to use a tourniquet to help manage the situation appropriately and prevent blood loss.