Which scenario would most likely require wound packing as part of hemorrhage control?

• A. Significant non-pulsatile bleeding
• B. Pulsatile arterial spurting bleeding
• C. Bleeding that stops with direct pressure
• D. Bleeding from a closed fracture

Answer: (A)

Wound packing is used when there’s ongoing, non-pulsatile bleeding from a wound cavity that surface pressure can’t fully control. By stuffing gauze into the wound, you create tamponade from within, pressing on the bleeding surfaces and promoting clotting to stop the bleed. This scenario fits best because the bleeding is significant but not arterial spurting, meaning internal sources of oozing within the wound want internal pressure to be controlled. In contrast, pulsatile spurting points to an arterial injury needing rapid tourniquet or surgical control; bleeding that stops with direct pressure doesn’t require packing; and bleeding from a closed fracture involves hidden internal bleeding not easily addressed by packing a surface wound.