Physical Education

Indirect Pressure

In cases of severe bleeding when direct pressure and elevation are not controlling the bleeding, indirect pressure must be used. Bleeding from an artery can be controlled by applying pressure to the appropriate pressure point. Pressure points (Fig. 3-2) are areas of the body where the blood flow can be controlled by pressing the artery against an underlying bone. Pressure is applied with the fingers, thumb, or heel of the hand.

Pressure points should be used with caution. Indirect pressure can cause damage to the extremity due to inadequate blood flow. Do not apply pressure to the neck (carotid) pressure points, it can cause cardiac arrest.

Indirect pressure is used in addition to direct pressure and elevation. Pressure points in the arm (brachial) and in the groin (femoral) are most often used, and should be thoroughly understood. The brachial artery is used to control severe bleeding of the lower part of the upper arm and elbow. It is located above the elbow on the inside of the arm in the groove between the muscles. Using your fingers or thumb, apply pressure (Fig. 3-2E) to the inside of the arm over the bone. The femoral artery is used to control severe bleeding of the thigh and lower leg. It is located on the front, center part of the crease in the groin. Position the casualty on his or her back, kneel on the opposite side (Fig. 3-2H ) from the wounded leg, place the heel of your hand directly on the pressure point, and lean forward to apply pressure. If the bleeding is not controlled, it may be necessary to press directly over the artery with the flat surface of the fingertips and to apply additional pressure on the fingertips with the heel of your other hand.