the level of the eyes, apply pressure to the point
on the mandible. This is shown in figure 4-21A.
To find this pressure point, start at the angle of
the jaw and run your finger forward along the
lower edge of the mandible until you feel a small
notch. The pressure point is in this notch.
If bleeding is in the shoulder or in the upper
part of the arm, apply pressure with the fingers
behind the clavicle. You can press down against
the first rib or forward against the clavicleeither
kind of pressure will stop the bleeding. This
pressure point is shown in figure 4-21B.
Bleeding between the middle of the upper arm
and the elbow should be controlled by applying
digital pressure in the inner (body) side of the arm,
about halfway between the shoulder and the
elbow. This compresses the artery against the bone
of the arm. The application of pressure at this
point is shown in figure 4-21C. Bleeding from the
hand can be controlled by pressure at the wrist,
as shown in figure 4-21D. If it is possible to hold
the arm up in the air, the bleeding will be relatively
easy to stop.
Figure 4-21E shows how to apply digital
pressure in the middle of the groin to control
bleeding from the thigh. The artery at this point
lies over a bone and quite close to the surface,
so pressure with your fingers may be sufficient
to stop the bleeding.
Figure 4-21F shows the proper position for
controlling bleeding from the foot. As in the case
of bleeding from the hand, elevation is helpful
in controlling the bleeding.
If bleeding is in the region of the temple or
the scalp, use your finger to compress the main
artery to the temple against the skull bone at the
pressure point just in front of the ear. Figure
4-21 G shows the proper position.
If the neck is bleeding, apply pressure below
the wound, just in front of the prominent neck
muscle. Press inward and slightly backward, com-
pressing the main artery of that side of the neck
against the bones of the spinal column. The ap-
plication of pressure at this point is shown in
figure 4-21 H. Do not apply pressure at this point
unless it is absolutely essential, since there is a
great danger of pressing on the windpipe and thus
choking the victim.
Bleeding from the lower arm can be controlled
by applying pressure at the elbow, as shown in
As mentioned before, bleeding in the upper
part of the thigh can sometimes be controlled by
applying digital pressure in the middle of the
groin, as shown in figure 4-21E. Sometimes,
however, it is more effective to use the pressure
point of the upper thigh, as shown in figure 4-21J.
If you use this point, apply pressure with the
closed fist of one hand and use the other hand
to give additional pressure. The artery at this point
is deeply buried in some of the heaviest muscle
of the body, so a great deal of pressure must be
exerted to compress the artery against the bone.
Bleeding between the knee and the foot may
be controlled by firm pressure at the knee. If
pressure at the side of the knee does not stop the
bleeding, hold the front of the knee with one hand
and thrust your fist hard against the artery behind
the knee, as shown in figure 4-21K. If necessary,
you can place a folded compress or bandage
behind the knee, bend the leg back, and hold it
in place by a firm bandage. This is a most effec-
tive way of controlling bleeding, but it is so un-
comfortable for the victim that it should be used
only as a last resort.
You should memorize these pressure points so
that you will know immediately which point to
use for controlling hemorrhage from a particular
part of the body. Remember, the correct pressure
point is that which is (1) NEAREST THE
WOUND, and (2) BETWEEN THE WOUND
AND THE MAIN PART OF THE BODY.
It is very tiring to apply digital pressure, and
it can seldom be maintained for more than 15
minutes. Pressure points are recommended for use
while direct pressure is being applied to a serious
wound by a second rescuer, or after a compress,
bandage, or dressing has been applied to the
wound, since it will slow the flow of blood to the
area, thus giving the direct pressure technique a
better chance to stop the hemorrhage. It is also
recommended as a stopgap measure until a
pressure dressing or a tourniquet can be applied.
The elevation of an extremity, where ap-
propriate, can be an effective aid in hemorrhage
control when used in conjunction with other
methods of control, especially direct pressure.
This is because the amount of blood entering the
extremity is decreased by the uphill gravitational
effect. Do not elevate an extremity until it is cer-
tain that no bones have been broken or until
broken bones are properly splinted.
Another effective method of hemorrhage con-
trol in cases of bone fractures is splinting. The