During management of a young female in a motor vehicle crash with a glass fragment impaled in the eye and a large forearm laceration with active venous bleeding, as your partner stabilizes the head you should

• A. Apply direct pressure to her arm wound
• B. Irrigate the eye wound immediately
• C. Remove the glass from the eye
• D. Apply pressure to the eye wound

Answer: (A)

In a multi-trauma situation, stopping life-threatening bleeding comes first. The forearm wound has active venous bleeding, which can quickly lead to shock if not controlled. While one provider stabilizes the head to protect the spine, your priority is to tamponade the bleeding by applying direct pressure to the arm wound with a clean dressing. This simple step is the most effective immediate measure to reduce blood loss and buy time for definitive care.

Eye injuries with a glass fragment impaled in the eye require careful handling and protection, not manipulation. Do not remove the object or aggressively touch the eye, and avoid irrigation. Instead, shield the eye with a rigid barrier or clean dressing to prevent movement and transport promptly for ophthalmologic assessment. These actions help preserve sight and prevent further damage while the patient is stabilized.